Provider Demographics
NPI:1992721054
Name:CARVALHO, GERARD JOAQUIM (MD)
Entity type:Individual
Prefix:DR
First Name:GERARD
Middle Name:JOAQUIM
Last Name:CARVALHO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:118 N SANTA FE ST
Mailing Address - Street 2:STE B
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-4441
Mailing Address - Country:US
Mailing Address - Phone:951-925-8811
Mailing Address - Fax:951-925-8860
Practice Address - Street 1:118 N SANTA FE ST
Practice Address - Street 2:STE B
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4441
Practice Address - Country:US
Practice Address - Phone:951-925-8811
Practice Address - Fax:951-925-8860
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA69700207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H95390Medicare UPIN
00A697000Medicare ID - Type Unspecified