Provider Demographics
NPI:1437265980
Name:HONRADO, CARLO P (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLO
Middle Name:P
Last Name:HONRADO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 CENTURY PARK EAST
Mailing Address - Street 2:SUITE 1701
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067
Mailing Address - Country:US
Mailing Address - Phone:310-286-0043
Mailing Address - Fax:424-206-4936
Practice Address - Street 1:2080 CENTURY PARK EAST
Practice Address - Street 2:SUITE 1701
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067
Practice Address - Country:US
Practice Address - Phone:310-286-0043
Practice Address - Fax:424-206-4936
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102560207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02578605Medicaid
NYH85623Medicare UPIN
NY7M6171Medicare ID - Type Unspecified