Provider Demographics
NPI:1811005671
Name:MOISES R. CARPIO, M.D., INC.
Entity Type:Organization
Organization Name:MOISES R. CARPIO, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOISES
Authorized Official - Middle Name:ROBERTO
Authorized Official - Last Name:CARPIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FCCP
Authorized Official - Phone:562-806-4040
Mailing Address - Street 1:9818 PARAMOUNT BOULEVARD
Mailing Address - Street 2:SUITE C
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-4406
Mailing Address - Country:US
Mailing Address - Phone:562-806-4040
Mailing Address - Fax:562-806-4644
Practice Address - Street 1:9818 PARAMOUNT BOULEVARD
Practice Address - Street 2:SUITE C
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-4406
Practice Address - Country:US
Practice Address - Phone:562-806-4040
Practice Address - Fax:562-806-4644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA33184A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A331840Medicaid
CAA33184AMedicare ID - Type Unspecified
CAA27065Medicare UPIN