| Carbon Health Medical Group Of Sunnyvale Inc | |
|
109 S Las Posas Rd Ste 101 San Marcos CA 92078-2419 | |
| (760) 258-4826 | |
| Not Available |
| Full Name | Carbon Health Medical Group Of Sunnyvale Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 109 S Las Posas Rd Ste 101, San Marcos, California |
| Authorized Official Name and Position | Kaitlin Boyle (DIRECTOR) |
| Authorized Official Contact | 3036015392 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carbon Health Medical Group Of Sunnyvale Inc 2100 Franklin St Ste 355 Oakland CA 94612-3140 Ph: (415) 446-1733 | Carbon Health Medical Group Of Sunnyvale Inc 109 S Las Posas Rd Ste 101 San Marcos CA 92078-2419 Ph: (760) 258-4826 |
| NPI Number | 1124701800 |
|---|---|
| Provider Enumeration Date | 08/09/2023 |
| Last Update Date | 07/09/2024 |
| Medicare PECOS PAC ID | 3173701877 |
|---|---|
| Medicare Enrollment ID | O20231111000489 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124701800 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Primary |
| Provider Name | Stephen M Daquino |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1346351665 PECOS PAC ID: 8325009582 Enrollment ID: I20041020001345 |
| Provider Name | Gregory L Wakeman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679663777 PECOS PAC ID: 6507893096 Enrollment ID: I20050726001186 |
| Provider Name | Christopher L Snyder |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922041235 PECOS PAC ID: 2860410867 Enrollment ID: I20051108000921 |
| Provider Name | Colin X Jairam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821272295 PECOS PAC ID: 7810052719 Enrollment ID: I20090209000683 |
| Provider Name | Jodean Nicolette |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962599720 PECOS PAC ID: 0941272850 Enrollment ID: I20090902000253 |
| Provider Name | Neeru K Singh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669672424 PECOS PAC ID: 8820122708 Enrollment ID: I20151230002140 |
| Provider Name | Nicholas Ward |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932546173 PECOS PAC ID: 9335432145 Enrollment ID: I20160801000518 |
| Provider Name | Melanie A. Pollack |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1659756906 PECOS PAC ID: 0345502019 Enrollment ID: I20180315001973 |
| Provider Name | Lalita Poon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205328317 PECOS PAC ID: 0749537447 Enrollment ID: I20180726002342 |
| Provider Name | Joseph A Molina |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689195307 PECOS PAC ID: 7810260973 Enrollment ID: I20210126000388 |
| Provider Name | Renzo M Corzano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669960324 PECOS PAC ID: 9032598677 Enrollment ID: I20220628001534 |
| Provider Name | Kristine Amy Cavan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588252662 PECOS PAC ID: 4284001595 Enrollment ID: I20221028002437 |
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