Individual
GARY ANDRE FIEBIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
8354 RESEDA BLVD, NORTHRIDGE, CA 91324-4619
(818) 701-5367
(818) 886-0545
Mailing address
8354 RESEDA BLVD, NORTHRIDGE, CA 91324-4619
(818) 701-5367
(818) 886-0545
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
2428SL1193
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ82127Z
—
CA
Enumeration date
05/18/2007
Last updated
02/08/2008
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