Individual
DONNA LYNN CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
700 E REDLANDS BLVD # 353, REDLANDS, CA 92373-6143
(951) 202-8010
Mailing address
700 E REDLANDS BLVD # 353, REDLANDS, CA 92373-6143
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
G19179
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G19179
—
CA
Enumeration date
11/04/2008
Last updated
11/04/2008
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