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Individual

MR. CARLETON THOMAS NIBLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2700 GRANT ST, SUITE 319, CONCORD, CA 94520-2266
(925) 674-2880
(925) 674-2883
Mailing address
DEPT 34929, P.O. BOX 39000, SAN FRANCISCO, CA 94139-0001
(925) 952-2828
(925) 952-2850

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
G81444
CA
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
G81444
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
035185
HILL PHYSICIANS PROV NUM
CA
01
DB0077
RAILROAD MC GRP NUMBER
CA
05
G81444
CA
05
GR0098120
CA
01
P00082303
RAILROAD MEDICARE
CA
01
P01312627
RAILROAD MEDICARE (JMH)
CA
01
ZZZ07991Z
BLUE SHIELD GROUP NUMBER
CA
01
ZZZ27532Z
MEDICARE GROUP NUMBER
Enumeration date
09/20/2006
Last updated
08/30/2016
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