Individual provider Active NPI

Carly Elizabeth Bliss, PHARMD

  • Clinical Pharmacology Physician
  • Palo Alto, CA
National Provider Identifier
1043857725
Registry record updated Dec 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pharmacology PhysicianTaxonomy code 208U00000X
License
PH60651922 Issued in WA
Practice address
3801 Miranda Ave
Palo Alto, CA 94304-1290
Phone
(650) 493-5000
NPI assigned
Dec 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pharmacology Physician 208U00000X PH60651922 WA Primary

Addresses

Primary practice location

3801 Miranda Ave
Palo Alto, CA 94304-1290

Mailing address

122 Middlefield Rd
Palo Alto, CA 94301-1340
Phone (858) 442-4094

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PH60651922WAMDClinical Pharmacology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1043857725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 MIDDLEFIELD RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943011340",
            "telephone_number": "858-442-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 MIRANDA AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041290",
            "telephone_number": "650-493-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLISS",
        "first_name": "CARLY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-02",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Pharmacology",
            "state": "WA",
            "license": "PH60651922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.