Carrillo, Martin Antonio

Carrillo, Martin Antonio is an individual health care provider with primary practice located at 5451 Walnut Ave , Chino CA 91710-2609. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Carrillo, Martin Antonio can be contacted via phone (909) 464-8666.

Contact Information

Primary practice address
5451 Walnut Ave Chino CA 91710-2609
Phone: (909) 464-8666
Fax: (909) 464-8913
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X G78590 California

Profile Details

NPI number 1861436339
LBN Legal business name Carrillo, Martin Antonio
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2006
Last updated Sep 1st, 2011 - about 15 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 1861436339 NPPES
California MEDICAID 00G785900

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