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Organization
CARRILLO MEDICAL GROUP PROFESSIONAL CORPORATION
Active
Organization
CARRILLO MEDICAL GROUP PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. INES SJOGRELL (MANAGER)
(925) 790-0760
Entity
Organization
Contact information
Practice address
1800 SULLIVAN AVE RM 101, DALY CITY, CA 94015-2227
(650) 994-0459
Mailing address
1800 SULLIVAN AVE RM 101, DALY CITY, CA 94015-2227
(650) 994-0459
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A51743
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A517430
—
CA
Enumeration date
02/16/2007
Last updated
09/15/2015
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