Individual
CARRIE LYNN CARLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
914 PINE STREET, MOUNT SHASTA, CA 96067-9688
(530) 926-9335
Mailing address
914 PINE STREET, MOUNT SHASTA, CA 96067-9688
(530) 926-9335
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD25479
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A108676
MEDICAL LICENSE
CA
01
—
MD25479
OREGON STATE LICENSE
OR
Enumeration date
11/09/2005
Last updated
05/26/2015
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