MEDICARE: DR. PETER JAMES CALLA O.D.

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	152W00000X	Optometrist	OEG000480	PA

General Provider Information

NPI Number	:	1093730459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER JAMES CALLA O.D.

Provider Business Mailing Address
First Line	:	2031 BELMONT AVE
Second Line	:	V.A. OUTPATIENT CLINIC
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44505-2401
Country	:	US
Telephone Number	:	330-740-9200
Fax Number	:	330-740-9240

Provider Business Practice Location Address
First Line	:	2031 BELMONT AVE
Second Line	:	V.A. OUTPATIENT CLINIC
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44505-2401
Country	:	US
Telephone Number	:	330-740-9200
Fax Number	:	330-740-9240

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	07/08/2007

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