Organization
CARL HALLER, MD, A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL HALLER M.D. (PRESIDENT, SOLE OWNER OF CORPORATIO)
(916) 483-3437
Entity
Organization
Contact information
Practice address
3609 MISSION AVE., STE D, CARMICHAEL (COUNTY OF SACRAMENTO), CA 95608-2955
(916) 483-3437
(916) 483-3218
Mailing address
3609 MISSION AVE., STE D, CARMICHAEL (COUNTY OF SACRAMENTO), CA 95608-2955
(916) 483-3437
(916) 483-3218
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
CALIFORNIAG9581
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136655214301
—
CA
Enumeration date
10/25/2012
Last updated
10/25/2012
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