Provider Demographics
NPI:1871594085
Name:SAY, CARLOS C (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:C
Last Name:SAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 E BELLEVUE RD
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:CA
Mailing Address - Zip Code:95301-2306
Mailing Address - Country:US
Mailing Address - Phone:209-358-6494
Mailing Address - Fax:209-358-6498
Practice Address - Street 1:329 E BELLEVUE RD
Practice Address - Street 2:
Practice Address - City:ATWATER
Practice Address - State:CA
Practice Address - Zip Code:95301-2306
Practice Address - Country:US
Practice Address - Phone:209-358-6494
Practice Address - Fax:209-358-6498
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA26702207QG0300X, 207RG0100X, 207RX0202X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A267020Medicaid
942334044OtherTAX ID NO
CA4874516Medicaid
CADDA267020Medicare ID - Type UnspecifiedMEDICARESUPPLIERNUMBER
CA00A267020Medicaid