Provider Demographics
NPI:1962891697
Name:CARRIERO FOOT AND ANKLE INC
Entity type:Organization
Organization Name:CARRIERO FOOT AND ANKLE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:KEENAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:CARRIEO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:760-642-7009
Mailing Address - Street 1:1524 SHIELDS AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2910
Mailing Address - Country:US
Mailing Address - Phone:760-518-6184
Mailing Address - Fax:760-753-5351
Practice Address - Street 1:310 SANTA FE DR STE 112
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5123
Practice Address - Country:US
Practice Address - Phone:760-642-7009
Practice Address - Fax:760-230-1453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-19
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4509261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center