Provider Demographics
NPI:1770728636
Name:CARCAMO MEDICAL CORPORATION
Entity type:Organization
Organization Name:CARCAMO MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSTAMI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:626-337-0676
Mailing Address - Street 1:14362 RAMONA BLVD.
Mailing Address - Street 2:CARCAMO MEDICAL CORPORATION
Mailing Address - City:BALDWIN PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91706-6241
Mailing Address - Country:US
Mailing Address - Phone:626-337-0676
Mailing Address - Fax:626-813-4342
Practice Address - Street 1:14362 RAMONA BLVD.
Practice Address - Street 2:
Practice Address - City:BALDWIN PARK
Practice Address - State:CA
Practice Address - Zip Code:91706-6241
Practice Address - Country:US
Practice Address - Phone:626-337-0676
Practice Address - Fax:626-813-4342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-08
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty