MEDICARE: DALCARA, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332H00000X	Eyewear Supplier	201535610619	CA

General Provider Information

NPI Number	:	1629522164
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DALCARA, LLC

Provider Business Mailing Address
First Line	:	3404 MERRIMAC RD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-1034
Country	:	US
Telephone Number	:	310-968-7369
Fax Number	:	323-651-3689

Provider Business Practice Location Address
First Line	:	3404 MERRIMAC RD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-1034
Country	:	US
Telephone Number	:	310-968-7369
Fax Number	:	323-651-3689

Authorized Official
Title or Position	:	OWNER
Name	:	MS. ALISON READ
Credential	:	RNFA
Telephone Number	:	310-968-7369

Provider Enumeration Date	:	08/13/2016
Last Update Date	:	08/13/2016

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