| Ethelred E Carter Medical Corp | |
|
1700 E Cesar E Chavez Ave Suite #3700 Los Angeles CA 90033-2424 | |
| (323) 260-7252 | |
| (323) 260-7864 |
| Full Name | Ethelred E Carter Medical Corp |
|---|---|
| Speciality | Internal Medicine |
| Location | 1700 E Cesar E Chavez Ave, Los Angeles, California |
| Authorized Official Name and Position | Ethelred E Carter (SOLE OWNER) |
| Authorized Official Contact | 3232607252 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ethelred E Carter Medical Corp 1700 E Cesar E Chavez Ave Suite #3700 Los Angeles CA 90033-2424 Ph: (323) 260-7252 | Ethelred E Carter Medical Corp 1700 E Cesar E Chavez Ave Suite #3700 Los Angeles CA 90033-2424 Ph: (323) 260-7252 |
| NPI Number | 1508109877 |
|---|---|
| Provider Enumeration Date | 04/04/2013 |
| Last Update Date | 04/05/2013 |
| Medicare PECOS PAC ID | 2668618562 |
|---|---|
| Medicare Enrollment ID | O20130419000375 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508109877 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | A29534 (California) | Primary |
| Provider Name | Ethelred E Carter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336247964 PECOS PAC ID: 2163410085 Enrollment ID: I20040430001229 |
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