Basic Information
| Provider Information | |||||||||
| NPI: | 1003948787 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MURALLES | ||||||||
| FirstName: | CARLOS | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1067 TREVECCA PL | ||||||||
| Address2: | |||||||||
| City: | CLAREMONT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917111441 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9093981220 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 933 S SUNSET AVE | ||||||||
| Address2: | |||||||||
| City: | WEST COVINA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917903410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6269606117 | ||||||||
| FaxNumber: | 6262277015 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | A34401 | CA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.