Individual
KEENAN SINCLAIR CARRIERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
310 SANTA FE DR STE 112, ENCINITAS, CA 92024-5123
(760) 642-7009
(760) 230-1453
Mailing address
310 SANTA FE DR STE 112, ENCINITAS, CA 92024-5123
(760) 642-7009
(760) 230-1453
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E4509
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03-0431018
TRICARE
CA
05
—
GR0093170
—
CA
01
—
ZZZ04918Z
BLUE SHIELD
CA
Enumeration date
09/29/2006
Last updated
03/17/2018
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