MEDICARE: CAROL A BUCHANAN OD

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	OPT 8323	CA

General Provider Information

NPI Number	:	1336153741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL A BUCHANAN OD

Provider Business Mailing Address
First Line	:	8440 BRENTWOOD BLVD STE F
Second Line	:
City	:	BRENTWOOD
State	:	CA
Zip	:	94513-1300
Country	:	US
Telephone Number	:	925-634-0303
Fax Number	:	925-634-0338

Provider Business Practice Location Address
First Line	:	8440 BRENTWOOD BLVD STE F
Second Line	:
City	:	BRENTWOOD
State	:	CA
Zip	:	94513-1300
Country	:	US
Telephone Number	:	925-634-0303
Fax Number	:	925-634-0338

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

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	07/12/2021

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