Basic Information
| Provider Information | |||||||||
| NPI: | 1417119827 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CARCAMO-MOLINA | ||||||||
| FirstName: | DAYANA | ||||||||
| MiddleName: | OTHONIE | ||||||||
| NamePrefix: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CARCAMO | ||||||||
| OtherFirstName: | DAYANA | ||||||||
| OtherMiddleName: | OTHONIE | ||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1007 41ST ST APT 441 | ||||||||
| Address2: | |||||||||
| City: | EMERYVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946083778 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3109484221 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2351 CLAY ST STE 380 | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941151931 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4156003954 | ||||||||
| FaxNumber: | 4157757437 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2008 | ||||||||
| LastUpdateDate: | 04/26/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 9406987 | KS | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0100X | A11529 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.