Provider Demographics
NPI:1790854487
Name:CAROLYN MCALOON DPM PC
Entity Type:Organization
Organization Name:CAROLYN MCALOON DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCALOON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:510-581-1484
Mailing Address - Street 1:20100 LAKE CHABOT RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546
Mailing Address - Country:US
Mailing Address - Phone:510-581-1484
Mailing Address - Fax:510-581-7779
Practice Address - Street 1:20100 LAKE CHABOT RD
Practice Address - Street 2:SUITE 2
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546
Practice Address - Country:US
Practice Address - Phone:510-581-1484
Practice Address - Fax:510-581-7779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4197213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E4197Medicaid
CA000E41970Medicare ID - Type Unspecified
CA000E4197Medicaid