Individual
CAROLYN M DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
400 N PEPPER AVE, MOB SUITE 308, COLTON, CA 92324-1801
(909) 580-3353
(909) 580-1363
Mailing address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-3353
(909) 580-1363
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
G61638
CA
207Y00000X
Otolaryngology Physician
Primary
G61638
CA
Other
Enumeration date
05/26/2006
Last updated
03/10/2020
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