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Individual

DR. DENEEN CHERRY DICARLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
77 CASA ST STE 101, SAN LUIS OBISPO, CA 93405-5804
(661) 695-8385
(805) 439-2765
Mailing address
8329 BRIMHALL RD, SUITE 801, BAKERSFIELD, CA 93312-2243
(661) 695-8385
(805) 439-2765

Taxonomy

Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
A98771
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CB206701
MEDICARE GROUP PTAN
CA
01
CB251372
MEDICARE INDIVIDUAL PTAN
CA
Enumeration date
09/29/2006
Last updated
09/27/2018
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