Thomas John Carpenter Jr, MD | |
100 W California Blvd, Pasadena, CA 91105-3010 | |
(626) 397-5000 | |
(626) 397-2912 |
Full Name | Thomas John Carpenter Jr |
---|---|
Gender | Male |
Speciality | Anesthesiology |
Location | 100 W California Blvd, Pasadena, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1073537064 | NPI | - | NPPES |
00G533230 | Medicaid | CA | |
00G533230 | Other | CA | BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207L00000X | Anesthesiology | G53323 (California) | Primary |
Entity Name | Pacific Valley Medical Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1851312862 PECOS PAC ID: 3577465368 Enrollment ID: O20040122000762 |
Mailing Address | Practice Location Address |
---|---|
Thomas John Carpenter Jr, MD 225 S Lake Ave, 535, Pasadena, CA 91101-3005 Ph: (626) 795-6596 | Thomas John Carpenter Jr, MD 100 W California Blvd, Pasadena, CA 91105-3010 Ph: (626) 397-5000 |
Austin Wu, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 100 W California Blvd, Pasadena, CA 91105 Phone: 310-267-8654 | |
Frederic Ransom Bushnell Iii, M.D. Anesthesiology Medicare: Medicare Enrolled Practice Location: 909 South Fair Oaks Avenue, Pasadena, CA 91105 Phone: 626-389-9300 Fax: 626-389-9336 | |
Luke Hyaryul Chang, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 100 W California Blvd, Pasadena, CA 91105 Phone: 626-397-5000 Fax: 626-397-2912 | |
Hayk Minasyan, Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2923 Bradley St Ste 120, Pasadena, CA 91107 Phone: 626-639-6214 | |
Kevin K Li, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2555 E Colorado Blvd Ste 306, Pasadena, CA 91107 Phone: 626-538-8950 Fax: 626-566-7620 | |
Ernest Keith Polk, M.D. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 100 W California Blvd, Pasadena, CA 91105 Phone: 626-397-5000 Fax: 626-397-2912 |