Individual
CAROL MARY HUMBLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
255 E SANTA CLARA ST, 240, ARCADIA, CA 91006-7226
(626) 254-1800
(626) 447-7145
Mailing address
225 S LAKE AVE, 535, PASADENA, CA 91101-3005
(626) 795-6596
(626) 795-8247
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G49241
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G492410
BLUE SHIELD
CA
05
—
00G492410
—
CA
Enumeration date
08/01/2006
Last updated
09/28/2007
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