MEDICARE: DR. DAVID DONALD CARLTON 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	06254T	CA

General Provider Information

NPI Number	:	1154342566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID DONALD CARLTON O.D.

Provider Business Mailing Address
First Line	:	410 S GLENDORA AVE SUITE 110
Second Line	:
City	:	GLENDORA
State	:	CA
Zip	:	91741
Country	:	US
Telephone Number	:	626-335-4021
Fax Number	:	626-335-9910

Provider Business Practice Location Address
First Line	:	410 S GLENDORA AVE STE 110
Second Line	:
City	:	GLENDORA
State	:	CA
Zip	:	91741-6207
Country	:	US
Telephone Number	:	626-335-4021
Fax Number	:	626-335-9910

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

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	05/20/2008

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