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Individual

DR. BRIAN ANTHONY DICARLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
892 AEROVISTA PL STE 240, SAN LUIS OBISPO, CA 93401-8054
(805) 541-8252
(805) 543-8252
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
A98389
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CB239193
MEDICARE ID
CA
Enumeration date
03/19/2007
Last updated
09/23/2019
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