Provider Demographics
NPI:1821013772
Name:CARNEGIE, SHERIE (D O)
Entity Type:Individual
Prefix:DR
First Name:SHERIE
Middle Name:
Last Name:CARNEGIE
Suffix:
Gender:F
Credentials:D O
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8142 FIRESTONE BLVD
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-4231
Mailing Address - Country:US
Mailing Address - Phone:562-869-8621
Mailing Address - Fax:569-231-1339
Practice Address - Street 1:8142 FIRESTONE BLVD
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-4231
Practice Address - Country:US
Practice Address - Phone:562-869-8621
Practice Address - Fax:569-231-1339
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A6691207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX6691Medicaid
CA954871483OtherBLUECROSS/BLUESHIELD
CAG18376Medicare UPIN
CA00AX6691Medicaid