Provider Demographics
NPI:1467624601
Name:DILEO, CHARLES V (OD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:V
Last Name:DILEO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:1401 W ESPLANADE AVE
Mailing Address - Street 2:STE 2020
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-2845
Mailing Address - Country:US
Mailing Address - Phone:504-465-0085
Mailing Address - Fax:504-465-0087
Practice Address - Street 1:1401 W ESPLANADE AVE
Practice Address - Street 2:STE 2020
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-2845
Practice Address - Country:US
Practice Address - Phone:504-465-0085
Practice Address - Fax:504-465-0087
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-27
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA934-223T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1900H1183ZOtherBLUECROSS BLUESHIELD OF L
LA1900H1183ZOtherBLUECROSS BLUESHIELD OF L
LA57069Medicare PIN