Provider Demographics
NPI:1417034729
Name:LECARA, EDWARD CHARLES (DC)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:CHARLES
Last Name:LECARA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7051 COMMERCE CIR
Mailing Address - Street 2:SUITE B
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-8028
Mailing Address - Country:US
Mailing Address - Phone:925-462-5557
Mailing Address - Fax:925-462-5560
Practice Address - Street 1:7051 COMMERCE CIR
Practice Address - Street 2:SUITE B
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-8028
Practice Address - Country:US
Practice Address - Phone:925-462-5557
Practice Address - Fax:925-462-5560
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26890111N00000X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU80095Medicare UPIN