MICHAEL P DECARLO OPTOMETRIST INC (NPI# 1336351998) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336351998 |
| Entity Type | Organization |
| Organization Name | MICHAEL P DECARLO OPTOMETRIST INC |
| Other Organization Name | MICHAEL P. DECARLO OPTOMETRIST, INC. |
| Practice Address |
1428 N Kraemer Blvd Placentia CA 92870 |
| Mailing Address |
1428 N Kraemer Blvd Placentia CA 92870-3406 |
| Practice Telephone | 7149961136 |
| Practice Fax Number | 7149960793 |
| Mailing Telephone | 7149961136 |
| Mailing Fax Number | 7149960793 |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2018-06-29 |
| Authorized Official Name | DR. MICHAEL P DECARLO (PRESIDENT) |
| Authorized Official Telephone | 5628812454 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152WL0500X |
Optometrist Specialization: Low Vision Rehabilitation |
9416T | CA | Eye and Vision Services Providers |
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | 9416TPG | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | SD0094160 7 | 05 |
| Other Name | Type Code |
|---|---|
| Michael P. DeCarlo Optometrist, Inc. | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5724 E 7th St, Long Beach, CA 908032002 | 5629866373 | 5629866377 |
| Street Address |
1428 N KRAEMER BLVD |
| City | PLACENTIA |
| State | CA |
| Zip Code | 92870 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346327673 | Michael P Decarlo | Optometrist | 1428 N Kraemer Blvd, Placentia, CA 92870 | 2006-11-01 |
| 1306213046 | Jarom B. Partridge | Optometrist | 1428 N Kraemer Blvd, Placentia, CA 92870-3406 | 2015-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952887499 | Makaela Mendelson | Speech-Language Pathologist | 240 South Placentia Avenue, Placentia, CA 92870 | 2018-07-18 |
| 1194186106 | Carrie Schultz | Licensed Vocational Nurse | 543 Del Rey Dr., Placentia, CA 92870 | 2016-03-18 |
| 1710350277 | Caremore Health Plan | Nurse Practitioner | 1325 N. Rose Drive #102, Placentia Linda, CA 92870 | 2015-11-05 |
| 1871999847 | Heather Ellen Johnson | Occupational Therapist | 740 S. Placentia Ave, Suite 100, Placentia, CA 92870 | 2014-11-18 |
| 1992101257 | Arcel Lopez Escoto | Physical Therapist | 740 S. Placentia Ave. Suite 100, Placentia, CA 92870 | 2014-11-14 |
| 1144642109 | Christine Taheran | Nurse Practitioner | 120 Downey Lane, Placentia, CA 92870 | 2014-01-10 |
| 1851644587 | Peter Glickman | Ophthalmology | 1050 E Yorba Linda Blvd., Suite 205, Placentia, CA 92870 | 2012-10-18 |
| 1396003844 | Jaymie Coria, D.d.s., Inc | Dentist | 302 E. Palm Drive, Suite #a, Placentia, CA 92870 | 2012-05-02 |
| 1164798609 | Adelina Rachi | Occupational Therapist | 740 S. Placentia Ave., Suite 100, Placentia, CA 92870 | 2012-03-29 |
| 1023305067 | Patricia Inez Byrne | Registered Nurse | 2001-d E. Orangethorpe Ave., Placentia, CA 92870 | 2011-06-28 |
| Find all providers in zip 92870 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902488 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 300 E Colorado Blvd Ste 128, Pasadena, CA 91101-2267 | 2020-11-02 |
| 1700485562 | Vision Faire Optometry, Inc. A Professional Optometric Corporation | Eyewear Supplier (Equipment, not the service) | 4213 Dale Rd Ste A-2, Modesto, CA 95356-8505 | 2020-10-22 |
| 1154929859 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 5500 W Sunset Blvd, Los Angeles, CA 90028 | 2020-10-14 |
| 1295333029 | Tiger & Lion Inc | Eyewear Supplier (Equipment, not the service) | 1251 S Beach Blvd Ste F, La Habra, CA 90631-6397 | 2020-10-14 |
| 1245866565 | Joshua Adolfo Velasquez | Eyewear Supplier (Equipment, not the service) | 849 N Ridgewood Pl, Los Angeles, CA 90038-4302 | 2020-03-18 |
| 1952948424 | Luvc LLC | Eyewear Supplier (Equipment, not the service) | 2223 Carlton Ave, Pomona, CA 91768-1015 | 2019-12-04 |
| 1568011377 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 6440 E. Pacific Coast Highway, Space B-165, Long Beach, CA 90803 | 2019-09-05 |
| 1184270746 | Nueyes Technologies Inc | Eyewear Supplier (Equipment, not the service) | 120 Newport Center Dr # 232, Newport Beach, CA 92660-6916 | 2019-08-09 |
| 1881248102 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 12182 1/2 Ventura Blvd, Studio City, CA 91604-2517 | 2019-07-25 |
| 1730732363 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 1628 Redwood Hwy Spc D017, Corte Madera, CA 94925-1248 | 2019-07-23 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MICHAEL P DECARLO OPTOMETRIST INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.