Provider Demographics
NPI:1629522164
Name:DALCARA, LLC
Entity Type:Organization
Organization Name:DALCARA, LLC
Other - Org Name:FREEZEFRAMES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:
Authorized Official - Last Name:READ
Authorized Official - Suffix:
Authorized Official - Credentials:RNFA
Authorized Official - Phone:310-968-7369
Mailing Address - Street 1:3404 MERRIMAC RD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-1034
Mailing Address - Country:US
Mailing Address - Phone:310-968-7369
Mailing Address - Fax:323-651-3689
Practice Address - Street 1:3404 MERRIMAC RD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-1034
Practice Address - Country:US
Practice Address - Phone:310-968-7369
Practice Address - Fax:323-651-3689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-13
Last Update Date:2016-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA201535610619332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
332H00000XMedicare PIN