OrganizationActive
Carmen Botero, MD
NPI 1063631802 · Pediatric Critical Care Medicine Physician · Tarzana, CA
Provider details
- NPI number
- 1063631802
- Entity type
- Organization
- Primary specialty
- Pediatric Critical Care Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Karen Hale, Business Office Manager(208) 762-6836
- License
- A47742 (CA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
18321 Clark St
Tarzana, CA 91356-3501
Phone: (208) 676-9080
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 570587
Tarzana, CA 91357-0587
Registry dates
- Enumerated
- 2007-04-24
- Last updated
- 2025-09-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.