Provider Demographics
NPI:1558347393
Name:BAYARDO, CARLOS F (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:F
Last Name:BAYARDO
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 1:155 S NEWMARK AVE
Mailing Address - Street 2:
Mailing Address - City:PARLIER
Mailing Address - State:CA
Mailing Address - Zip Code:93648-2531
Mailing Address - Country:US
Mailing Address - Phone:559-646-1200
Mailing Address - Fax:559-646-6622
Practice Address - Street 1:155 S NEWMARK AVE
Practice Address - Street 2:
Practice Address - City:PARLIER
Practice Address - State:CA
Practice Address - Zip Code:93648-2531
Practice Address - Country:US
Practice Address - Phone:559-646-1200
Practice Address - Fax:559-646-6622
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA91684207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A916840Medicaid
CAA916840Medicaid
CA00A916840Medicaid
CAI23830Medicare UPIN
CAAU998ZMedicare PIN