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MR. CRAIG JOHN CARBONNIERE P.A.

>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1063578110

Individual Registrant:
MR. CRAIG JOHN CARBONNIERE P.A.
Gender: M
Sole Proprietor

Location and contact information for practice:
5203 LAKEWOOD BLVD  LAKEWOOD, CA 90712-2438 US
Tel: 562-633-2273  Fax: --

Contact information for business:
7692 ELLIS AVE  HUNTINGTON BEACH, CA 92648-1635 US
Tel: 909-217-4321  Fax: --

Registration Information:
NPI: 1063578110
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
CAPA10492

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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