Provider Demographics
NPI:1437110749
Name:CAMARA, DAVID F (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:F
Last Name:CAMARA
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:PO BOX 2700
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91376-2700
Mailing Address - Country:US
Mailing Address - Phone:818-707-8567
Mailing Address - Fax:818-707-8567
Practice Address - Street 1:855 W FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:MONROVIA
Practice Address - State:CA
Practice Address - Zip Code:91016-1938
Practice Address - Country:US
Practice Address - Phone:818-707-8567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2009-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT10484T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1306035118OtherNPI - ADVANCED EYECARE GROUP
CASD0104840OtherMEDI-CAL
CTDP2509OtherRAILROAD MEDICARE PIN - ADVANCED EYECARE, INC.
CA410044901OtherPALMETTO
CA6191070001OtherDMEPOS - ADVANCED EYECARE GROUP PTAN
CAWOP10484CMedicare PIN
CA1306035118OtherNPI - ADVANCED EYECARE GROUP
CABF492AMedicare PIN
CAOP10484Medicare ID - Type Unspecified
CABP198Medicare PIN