Provider Demographics
NPI:1578765798
Name:CARR, ALFRED DODD (OD)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:DODD
Last Name:CARR
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 1:848 PEARMAN CT
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-8615
Mailing Address - Country:US
Mailing Address - Phone:530-895-0718
Mailing Address - Fax:
Practice Address - Street 1:1982 E 20TH ST
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-6342
Practice Address - Country:US
Practice Address - Phone:530-342-4180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4562T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0045620Medicare UPIN