Individual
DR. ERIC R CARLBLOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2425 PORTER ST, SUITE 6, SOQUEL, CA 95073-2444
(831) 462-1500
(831) 462-1503
Mailing address
PO BOX 339, SOQUEL, CA 95073-0339
(831) 462-1500
(831) 462-1503
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G65524
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G655240
—
CA
05
—
1962698167
—
CA
Enumeration date
07/24/2006
Last updated
02/18/2016
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