Provider Demographics
NPI:1942378948
Name:PASTOR, CARMEN LUZ (MD)
Entity Type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:LUZ
Last Name:PASTOR
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Gender:F
Credentials:MD
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Mailing Address - Street 1:21475 RIDGETOP CIR
Mailing Address - Street 2:SUITE 350
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-6580
Mailing Address - Country:US
Mailing Address - Phone:703-430-6211
Mailing Address - Fax:703-430-1414
Practice Address - Street 1:21475 RIDGETOP CIR
Practice Address - Street 2:SUITE 350
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-6580
Practice Address - Country:US
Practice Address - Phone:703-430-6211
Practice Address - Fax:703-430-1414
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
VA0101057623207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5874521Medicaid
VAH70557Medicare UPIN