Provider Demographics
NPI:1083688675
Name:CARVER, DAN B (OD)
Entity Type:Individual
Prefix:DR
First Name:DAN
Middle Name:B
Last Name:CARVER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11180 WARNER AVE STE 261
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-7516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11180 WARNER AVE STE 261
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-7516
Practice Address - Country:US
Practice Address - Phone:714-263-0800
Practice Address - Fax:714-263-2336
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-13
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6176TLG152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOP6176Medicare ID - Type Unspecified
CAT-70094Medicare UPIN