Provider Demographics
NPI:1245716224
Name:CARANDANG, CARLO (MD)
Entity type:Individual
Prefix:DR
First Name:CARLO
Middle Name:
Last Name:CARANDANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2793 CONNAUGHT AVE.
Mailing Address - Street 2:
Mailing Address - City:HALIFAX
Mailing Address - State:NOVA SCOTIA
Mailing Address - Zip Code:B3L 2Z8
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:848 OLIVE LN
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-8849
Practice Address - Country:US
Practice Address - Phone:902-222-0945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-13
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA364962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry