Carbon Health East Bay Primary Care PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

CARBON HEALTH EAST BAY PRIMARY CARE PC

Practice address

5829 Lone Tree Way # D110
Antioch, CA 94531-8603

Phone

(925) 204-3715

Fax

(888) 972-1912

NPI assigned

Mar 31, 2022

Organization subpart

No

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

Authorized official

Name

Kaitlin Boyle

Title

Director

Phone

(303) 601-5392

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721088000000",
    "number": "1134869746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CALIFORNIA ST FL 7",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941041415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5829 LONE TREE WAY # D110",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945318603",
            "telephone_number": "925-204-3715",
            "fax_number": "888-972-1912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARBON HEALTH EAST BAY PRIMARY CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-31",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A",
        "authorized_official_last_name": "BOYLE",
        "authorized_official_first_name": "KAITLIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "303-601-5392"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shenique Canidate
• Mariah Cannady
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• Anthony Carandang, MD
• Carbon Health East Bay Medical Group PC
• Cassandra Carbon
• Cheryl Elizabeth Carbon
• Melinda Suzanne Carchidi
• Chantel Cardoza
• Carepack Pharmacy LLC

• Primary Care Clinic/Center in Antioch, CA
• Providers in Antioch, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.