Organization
ANNA CARRILLO, M.D., A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA CARRILLO M.D. (PRESIDENT)
(858) 848-4028
Entity
Organization
Contact information
Practice address
11665 AVENA PL STE 204, SAN DIEGO, CA 92128-2428
(858) 848-4028
(858) 381-9769
Mailing address
PO BOX 500226, SAN DIEGO, CA 92150-0226
(858) 848-4028
(858) 381-9769
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
A62084
CA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A62084
—
CA
Enumeration date
07/14/2006
Last updated
04/01/2025
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