Organization
CARLOS R CANIZALES MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS R CANIZALES M.D. (OWNER)
(909) 981-5923
Entity
Organization
Contact information
Practice address
685 N 13TH AVE, SUITE 9, UPLAND, CA 91786-4916
(909) 981-5923
(909) 920-3054
Mailing address
305 N. 2ND AVENUE, SUITE 203, UPLAND, CA 91786
(909) 981-5923
(909) 920-3054
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A212830
—
CA
Enumeration date
06/04/2007
Last updated
02/23/2015
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