Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 6176TLG | CA |
NPI | 1083688675 |
---|---|
Provider Name | Dr. Dan B. Carver |
First Address | Fountain Valley, CA 92708-7516 |
Second Address | Fountain Valley, CA 92708-7516 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2006 |
Last Update Date | 22/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T-70094 | (02) | CA |