Carolyn Antes, R.D.C.S. (AE, PE)

Individual provider Active NPI Sonography Specialist/Technologist Cardiovascular · Carson, CA

NPI 1003168659 · NPPES record last updated Oct 6, 2012

Key facts

NPI
1003168659
Entity type
Individual (NPI type 1)
Primary specialty
Sonography Specialist/Technologist Cardiovascular 246XS1301X
License
139536 (CA)
Practice address
21311 S Troyton LN
Carson, CA 90745-1601
Phone
(310) 487-1646
Fax
(310) 693-9726
NPI assigned
Oct 6, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
139536CAMDSonography Specialist/Technologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Sonography Specialist/Technologist Cardiovascular 246XS1301X 139536 CA Yes

Addresses

Primary practice location

21311 S Troyton LN
Carson, CA 90745-1601

Mailing address

21311 S Troyton LN
Carson, CA 90745-1601
Phone (310) 487-1646

Other providers in Carson, CA

All providers in Carson, CA · Sonography Specialist/Technologist Cardiovascular in California

Sources for this page

Verify at the official NPI Registry.