Carlson, Charlotte Mary

Carlson, Charlotte Mary is an individual health care provider with primary practice located at 2455 Summerfield Rd , Santa Rosa CA 95405-7815. She recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as her primary health care specialty. Carlson, Charlotte Mary can be contacted via phone (707) 308-2815.

Contact Information

Primary practice address
2455 Summerfield Rd Santa Rosa CA 95405-7815
Phone: (707) 308-2815
Fax: (707) 573-5439
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 1009320 California

Profile Details

NPI number 1134446875
LBN Legal business name Carlson, Charlotte Mary
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2010
Last updated Jan 29th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134446875 NPPES
California Other A119269 STATE MEDICAL LICENSE

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