Provider Demographics
NPI:1134363294
Name:CARUSO, JOHN CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CHARLES
Last Name:CARUSO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3848 CAMPUS DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2610
Mailing Address - Country:US
Mailing Address - Phone:949-724-9977
Mailing Address - Fax:949-724-1758
Practice Address - Street 1:3848 CAMPUS DR
Practice Address - Street 2:SUITE 120
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2610
Practice Address - Country:US
Practice Address - Phone:949-724-9977
Practice Address - Fax:949-724-1758
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG081496208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery