Provider Demographics
NPI:1568502185
Name:LUPEI, CARL VICTOR (OD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:VICTOR
Last Name:LUPEI
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 1:7782 W SAHARA AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-2700
Mailing Address - Country:US
Mailing Address - Phone:702-254-7600
Mailing Address - Fax:702-254-0978
Practice Address - Street 1:7782 W SAHARA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2700
Practice Address - Country:US
Practice Address - Phone:702-254-7600
Practice Address - Fax:702-254-0978
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV218152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVU81597Medicare UPIN
NV37252Medicare PIN
P00657047Medicare PIN