MEDICARE: DR. ARISTIDES CARCAMO 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	8144T	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	BG153A	OTHER	CA	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891762894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARISTIDES CARCAMO O.D.

Provider Business Mailing Address
First Line	:	1000 VALENCIA ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-2406
Country	:	US
Telephone Number	:	415-826-2020
Fax Number	:	650-556-1802

Provider Business Practice Location Address
First Line	:	1000 VALENCIA ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-3144
Country	:	US
Telephone Number	:	415-826-2020
Fax Number	:	650-556-1802

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

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	10/13/2011

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