Individual
CARL JEFFREY CARLSON
Active
Individual
CARL JEFFREY CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G29295
CA
207RI0011X
Interventional Cardiology Physician
G29295
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G292950
BLUECROSS AND BLUESHIELD
CA
05
—
00G292950
—
CA
01
—
060006330
RAILROAD MEDICARE
CA
01
—
A44008
COMMERCIAL
CA
Enumeration date
07/12/2006
Last updated
03/18/2011
Update your record
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