Provider Demographics
NPI:1578537445
Name:CARATAO, OFELIA (MD)
Entity Type:Individual
Prefix:DR
First Name:OFELIA
Middle Name:
Last Name:CARATAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W SHERYL CIR
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90745-5144
Mailing Address - Country:US
Mailing Address - Phone:310-834-0419
Mailing Address - Fax:310-326-3386
Practice Address - Street 1:2232 SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-5301
Practice Address - Country:US
Practice Address - Phone:310-784-8131
Practice Address - Fax:310-326-3386
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC50314208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC50314OtherLICENSE