Organization
DONALD E. TEAGLE, OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD EDWARD TEAGLE OD (OWNER)
(818) 956-0873
Entity
Organization
Contact information
Practice address
1321 GLENDALE GALLERIA, GLENDALE, CA 91210-1400
(818) 956-0873
(818) 956-7015
Mailing address
1321 GLENDALE GALLERIA, GLENDALE, CA 91210-1400
(818) 956-0873
(818) 956-7015
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
04/08/2008
Last updated
04/08/2008
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