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Individual
MICHAEL LEE HOLUB
Active
Individual
MICHAEL LEE HOLUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT6250T
CA
152W00000X
Optometrist
OPT6250TPA
CA
152WC0802X
Corneal and Contact Management Optometrist
OPT6250TPA
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2673
DAVIS VISION PROVIDER NUM
CA
01
—
6517
MESC PROVIDER NUMBER
CA
01
—
SD00625000
B/C B/S IDENTIFIER
CA
01
—
ZZ40293Z
B/C B/S GROUP IDENTIFIER
CA
Enumeration date
01/23/2006
Last updated
12/23/2008
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