Provider Demographics
NPI:1497913032
Name:CARINO, ERIC E (OT)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:E
Last Name:CARINO
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72670 FRED WARING DR
Mailing Address - Street 2:STE 203
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-5013
Mailing Address - Country:US
Mailing Address - Phone:760-285-4434
Mailing Address - Fax:
Practice Address - Street 1:72670 FRED WARING DR
Practice Address - Street 2:STE 203
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-5013
Practice Address - Country:US
Practice Address - Phone:760-285-4434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-30
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4416208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4416OtherOT LICENSE