Provider Demographics
NPI:1508913674
Name:AHROON, CARL R (MD)
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:R
Last Name:AHROON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:724 MEDICAL CENTER DR E
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-6811
Mailing Address - Country:US
Mailing Address - Phone:559-323-1610
Mailing Address - Fax:559-323-1760
Practice Address - Street 1:724 MEDICAL CENTER DR E
Practice Address - Street 2:SUITE 101
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-6811
Practice Address - Country:US
Practice Address - Phone:559-323-1610
Practice Address - Fax:559-323-1760
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2010-03-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG13598207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG13598Medicare UPIN