Provider Demographics
NPI:1689828105
Name:CARMELITA UY MD INC
Entity Type:Organization
Organization Name:CARMELITA UY MD INC
Other - Org Name:CARMELITA Y MD INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARMELITA
Authorized Official - Middle Name:LUNA
Authorized Official - Last Name:UY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-216-8500
Mailing Address - Street 1:2340 EAST 8TH STREET
Mailing Address - Street 2:SUITE-E
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-2870
Mailing Address - Country:US
Mailing Address - Phone:619-216-8500
Mailing Address - Fax:619-216-8511
Practice Address - Street 1:2340 EAST 8TH STREET
Practice Address - Street 2:SUITE-E
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-2870
Practice Address - Country:US
Practice Address - Phone:619-216-8500
Practice Address - Fax:619-216-8511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-11
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC50548208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C505480Medicaid
CA3957538Medicaid