Provider Demographics
NPI:1427375781
Name:OVERMAN, CAROLYN MAHER (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:MAHER
Last Name:OVERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CAROLYN
Other - Middle Name:ANN
Other - Last Name:MAHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6041 CADILLAC AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-1702
Mailing Address - Country:US
Mailing Address - Phone:323-857-3161
Mailing Address - Fax:
Practice Address - Street 1:6041 CADILLAC AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-1702
Practice Address - Country:US
Practice Address - Phone:323-857-3161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-27
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA124441207P00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine