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Individual

DR. DONALD EDWARD TEAGLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
1321 GLENDALE GALLERIA, GLENDALE, CA 91210-1400
(818) 956-0873
(818) 956-1307
Mailing address
1321 GLENDALE GALLERIA, GLENDALE, CA 91210-1400
(818) 956-0873
(818) 956-1307

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9454T
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GSD005100
CA
Enumeration date
01/23/2007
Last updated
07/09/2007
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