Individual
GARY ROY CARLSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1240 S WESTLAKE BLVD, SUITE 205, WESTLAKE VILLAGE, CA 91361-1929
(805) 495-0551
(805) 496-8079
Mailing address
1240 S WESTLAKE BLVD, SUITE 205, WESTLAKE VILLAGE, CA 91361-1929
(805) 495-0551
(805) 496-8079
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G39594
CA
Other
Enumeration date
03/24/2006
Last updated
07/08/2007
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