Provider Demographics
NPI:1962508960
Name:ISAACS, CAROL L (MD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:L
Last Name:ISAACS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:10 WOODLAND RD
Mailing Address - Street 2:LLOYD BLDG STE 501
Mailing Address - City:ST HELENA
Mailing Address - State:CA
Mailing Address - Zip Code:94574-9554
Mailing Address - Country:US
Mailing Address - Phone:707-963-5450
Mailing Address - Fax:707-963-6543
Practice Address - Street 1:10 WOODLAND RD
Practice Address - Street 2:LLOYD BLDG STE 501
Practice Address - City:ST HELENA
Practice Address - State:CA
Practice Address - Zip Code:94574-9554
Practice Address - Country:US
Practice Address - Phone:707-963-5450
Practice Address - Fax:707-963-6543
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG53773207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G537730Medicaid
CA00G537730Medicaid
A52593Medicare UPIN