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Individual
DR. MICHAEL P DECARLO
Active
Individual
DR. MICHAEL P DECARLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9416TPG
CA
152WC0802X
Corneal and Contact Management Optometrist
9416TPG
CA
152WL0500X
Low Vision Rehabilitation Optometrist
9416T
CA
152WX0102X
Occupational Vision Optometrist
9416TPG
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0094160 7
—
CA
Enumeration date
11/01/2006
Last updated
10/17/2018
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