Donna Lynn Carlson, MD

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

G19179 Issued in CA

Practice address

700 E Redlands Blvd # 353
Redlands, CA 92373-6143

Phone

(951) 202-8010

NPI assigned

Nov 4, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1225756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225756800000",
    "number": "1871747824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E REDLANDS BLVD # 353",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923736143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E REDLANDS BLVD # 353",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923736143",
            "telephone_number": "951-202-8010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "DONNA",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-04",
        "last_updated": "2008-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CA",
            "license": "G19179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G19179",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caremark LLC
• Caremark, L.L.C. (CVS/Specialty)
• Carlos a Macias Medical Corporation
• Kerry Carlos, LAC
• Malyssa Robin Carlos, MA
• Richard Michael Carlson, DC
• Claudia Ruth Carmona, M.D.
• Nicole Vanessa Carmona
• Peter Caro, LCSW
• Caroline Le, DDS, a Professional Corporation

• Pediatric Adolescent Medicine Physician in Redlands, CA
• Providers in Redlands, CA by specialty
• Pediatric Adolescent Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2008; 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.