Provider Demographics
NPI:1952336968
Name:CARTER, PATRICIA SIMS (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:SIMS
Last Name:CARTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1450 TREAT BLVD # 300
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-2168
Mailing Address - Country:US
Mailing Address - Phone:925-952-2828
Mailing Address - Fax:925-952-2850
Practice Address - Street 1:5720 STONERIDGE MALL RD
Practice Address - Street 2:SUITE 330
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-2831
Practice Address - Country:US
Practice Address - Phone:925-225-1234
Practice Address - Fax:925-225-9219
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG86216207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH56029Medicare UPIN
CAPOO694180- RAILROADMedicare PIN
CA00G862162Medicare PIN