Individual
ANTONIO CARBAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1911 N BROADWAY, SANTA ANA, CA 92706-2609
(714) 667-6900
(714) 667-6116
Mailing address
1911 N BROADWAY, SANTA ANA, CA 92706-2609
(714) 667-6900
(714) 667-6116
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G79962
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G799620
—
CA
Enumeration date
07/03/2006
Last updated
11/19/2018
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