Basic Information
Provider Information
NPI: 1215106562
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BIEL
FirstName: CARLOS
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2750 E WASHINGTON BLVD STE 230
Address2:  
City: PASADENA
State: CA
PostalCode: 911071449
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 2750 E WASHINGTON BLVD STE 230
Address2:  
City: PASADENA
State: CA
PostalCode: 911071449
CountryCode: US
TelephoneNumber: 6262968900
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/20/2008
LastUpdateDate: 06/10/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/24/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
171M00000X  Y Other Service ProvidersCase Manager/Care Coordinator 

No ID Information.


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