Active NPI
Carlos Jose Carrera, M.D.
- Hematology (Internal Medicine) Physician
- San Diego, CA
National Provider Identifier
1417050345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology (Internal Medicine) Physician
- License
- G33363
- Practice address
- Ucsd Medical Center
200 West Arbor Dr, MC 8201
San Diego, CA 92103-8201 - Phone
- (858) 534-5407
- Fax
- (619) 543-3183
- NPI assigned
- Sep 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | G33363 | CA | |
| Hematology (Internal Medicine) Physician | 207RH0000X | G33363 | CA | Primary |
| Medical Oncology Physician | 207RX0202X | G33363 | CA | |
| Hematology & Oncology Physician | 207RH0003X | G33363 | CA |
Addresses
Primary practice location
Ucsd Medical Center
200 West Arbor Dr, MC 8201
San Diego, CA 92103-8201
Mailing address
3855 Health Sciences Dr
Moores Ucsd Cancer Center 0698
La Jolla, CA 92093-0698
Phone (858) 534-5407
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G333630 | Medicaid | CA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G33363 | CA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278633600000",
"number": "1417050345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3855 HEALTH SCIENCES DR",
"address_2": "MOORES UCSD CANCER CENTER 0698",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920930698",
"telephone_number": "858-534-5407",
"fax_number": "858-822-5383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "UCSD MEDICAL CENTER",
"address_2": "200 WEST ARBOR DR, MC 8201",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921038201",
"telephone_number": "858-534-5407",
"fax_number": "619-543-3183"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRERA",
"first_name": "CARLOS",
"middle_name": "JOSE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-06",
"last_updated": "2010-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "G33363",
"primary": false
},
{
"code": "207RH0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology",
"state": "CA",
"license": "G33363",
"primary": true
},
{
"code": "207RX0202X",
"taxonomy_group": "",
"desc": "Internal Medicine, Medical Oncology",
"state": "CA",
"license": "G33363",
"primary": false
},
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "CA",
"license": "G33363",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G333630",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.