Provider Demographics
NPI:1689652893
Name:ADAMS, CARLTON ZELLIOT JR (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLTON
Middle Name:ZELLIOT
Last Name:ADAMS
Suffix:JR
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 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6555 COYLE AVE STE 190
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-0303
Practice Address - Country:US
Practice Address - Phone:916-536-2582
Practice Address - Fax:916-536-2583
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN187752086S0129X
CAG682212086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNF31307Medicare UPIN
TN3068821Medicare ID - Type Unspecified
TN3068827Medicare ID - Type Unspecified