Organization
MICHAEL P DE CARLO OPTOMETRIST INC
Active
Other names
Michael P. DeCarlo Optometrist, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL P DECARLO O.D. (PRESIDENT)
(562) 881-2454
Entity
Organization
Contact information
Practice address
1428 N KRAEMER BLVD, PLACENTIA, CA 92870
(714) 996-1136
(714) 996-0793
Mailing address
1428 N KRAEMER BLVD, PLACENTIA, CA 92870-3406
(714) 996-1136
(714) 996-0793
Taxonomy
Speciality
Code
Description
License number
State
152WL0500X
Low Vision Rehabilitation Optometrist
9416T
CA
332H00000X
Eyewear Supplier
Primary
9416TPG
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0094160 7
—
CA
Enumeration date
05/04/2007
Last updated
03/03/2023
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