NPIMap

Organization Active NPI

Deneen C Dicarlo MD Inc a Prof Corp

  • Rheumatology Physician
  • Pismo Beach, CA
National Provider Identifier
1104072917
Registry record updated Jan 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
A98771 Issued in CA
Legal business name
DENEEN C DICARLO MD INC A PROF CORP
Practice address
901 Oak Park Blvd
Suite 101
Pismo Beach, CA 93449-3408
Phone
(805) 489-8039
NPI assigned
Aug 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2012

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

Authorized official

Name
Dr. Deneen C Dicarlo, MD
Title
Rheumatologist
Phone
(718) 490-7013

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X A98771 CA Primary

Addresses

Primary practice location

901 Oak Park Blvd
Suite 101
Pismo Beach, CA 93449-3408

Mailing address

901 Oak Park Blvd
Suite 101
Pismo Beach, CA 93449-3408
Phone (805) 489-8039

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326412800000",
    "number": "1104072917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 OAK PARK BLVD",
            "address_2": "SUITE 101",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934493408",
            "telephone_number": "805-489-8039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 OAK PARK BLVD",
            "address_2": "SUITE 101",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934493408",
            "telephone_number": "805-489-8039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENEEN C DICARLO MD INC A PROF CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-12",
        "last_updated": "2012-01-13",
        "status": "A",
        "authorized_official_last_name": "DICARLO",
        "authorized_official_first_name": "DENEEN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "RHEUMATOLOGIST",
        "authorized_official_telephone_number": "718-490-7013",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CA",
            "license": "A98771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pismo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; 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.