Carmen Botero, MD

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

A47742 Issued in CA

Legal business name

CARMEN BOTERO, MD

Practice address

18321 Clark St
Tarzana, CA 91356-3501

Phone

(208) 676-9080

NPI assigned

Apr 24, 2007

Organization subpart

No

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

Authorized official

Name

Karen Hale

Title

Business Office Manager

Phone

(208) 762-6836

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1063631802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 570587",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913570587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18321 CLARK ST",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563501",
            "telephone_number": "208-676-9080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARMEN BOTERO, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "HALE",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "208-762-6836"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CA",
            "license": "A47742",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "CA",
            "license": "A47742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A477420",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "ZZZ01458Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carissa Home Health, Inc.
• Carissa Hospice, Inc.
• Kyle Carlson
• Carlton B Sampson MD Inc
• E Duane Carmalt, M.D.
• Brenda Carnese
• Carolyn N. Quetzal
• Daniel J Carpenter
• Elias S. Carranza
• Joselin Elizabeth Carranza, CMT

• Pediatric Critical Care Medicine Physician in Tarzana, CA
• Providers in Tarzana, CA by specialty
• Pediatric Critical Care Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.