Individual
CARLO FERNANDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
1524 MCHENRY AVE, MODESTO, CA 95350-4500
(209) 722-4842
Mailing address
7916 LAKE ST, RIVER FOREST, IL 60305-1711
(708) 567-0007
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A17851
CA
207Q00000X
Family Medicine Physician
5101022830
MI
Other
Enumeration date
04/21/2016
Last updated
06/17/2025
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