Individual
DR. CARLOS R CANIZALES
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
685 N 13TH AVE, #9, UPLAND, CA 91786
(909) 981-5923
(909) 920-3054
Mailing address
305 N 2ND AVE, #203, UPLAND, CA 91786-6064
(909) 981-5923
(909) 920-3054
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A21283
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A212830
—
CA
Enumeration date
04/21/2006
Last updated
07/08/2007
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