Individual
MISS CHARLOTTE MARY CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2455 SUMMERFIELD RD, SANTA ROSA, CA 95405-7815
(707) 308-2815
(707) 573-5439
Mailing address
2455 SUMMERFIELD RD, SANTA ROSA, CA 95405-7815
(707) 308-2815
(707) 573-5439
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
1009320
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A119269
STATE MEDICAL LICENSE
CA
Enumeration date
04/20/2010
Last updated
01/29/2020
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