Dr. Carmen Julia Botero, M.D.
Pediatrics in Encino, CA. Individual provider (NPI-1).
NPI number1649375239
StatusActive
Last updated in NPPESOct 16, 2012
Details
- NPI
- 1649375239
- Entity type
- Individual (NPI-1)
- Name
- Dr. Carmen Julia Botero
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 14, 2006
- Last updated
- Oct 16, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | A47742 | CA | Yes |
| 2080P0202X | Pediatrics, Pediatric Cardiology | A47742 | CA | |
| 2080P0203X | Pediatrics, Pediatric Critical Care Medicine | A47742 | CA |
Practice location
5353 Balboa Blvd Ste 201Encino, CA 91316-2865
Phone 818-788-5437 · Fax 818-788-5436
Mailing address
Po Box 571027Tarzana, CA 91357-1027
Phone 818-343-5794 · Fax 919-343-5793
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