Carl J Carlson MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

G29295 Issued in CA

Legal business name

CARL J CARLSON MD

Practice address

1895 Mowry Ave
Suite #100
Fremont, CA 94538-1737

Phone

(510) 792-2012

Fax

(510) 792-7986

NPI assigned

May 22, 2007

Organization subpart

No

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

Authorized official

Name

Catherine Carlson, R.N.

Title

Office Manager

Phone

(510) 792-2012

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carl Jeffrey Carlson, M.D.

  • Cardiovascular Disease Physician
  • Fremont, CA
  • NPI 1386669489
  NPD (past)
• Joyce A Beck, ANP

  • Nurse Practitioner
  • Redmond, OR
  • NPI 1245356815
  NPD (past)

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245628800000",
    "number": "1508075540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1895 MOWRY AVE",
            "address_2": "SUITE #100",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381737",
            "telephone_number": "510-792-2012",
            "fax_number": "510-792-7986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1895 MOWRY AVE",
            "address_2": "SUITE #100",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381737",
            "telephone_number": "510-792-2012",
            "fax_number": "510-792-7986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARL J CARLSON MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2009-06-22",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "510-792-2012",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G29295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS AND BLUESHIELD",
            "identifier": "ZZZ26021Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G292950",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HILL PHYSICIANS",
            "identifier": "000169",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angelique Cardoza
• Karen Mari Cardoza
• Care in Touch Home Health Agency
• Care2U
• Stacey S Cariaso, L.C.S.W.
• Bonnie Lee Carlson
• Carl Jeffrey Carlson, M.D.
• Joshua Carlson
• Mark Anthony Carlton, LVN
• Jeffrey Alan Carmel, MD

• Cardiovascular Disease Physician in Fremont, CA
• Providers in Fremont, CA by specialty
• Cardiovascular Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2009; 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.