Individual
MR. DOUGLAS EBBINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
1808 VERDUGO BLVD, #120 VERDUGO OPTICAL, GLENDALE, CA 91208-1477
(818) 952-1124
(818) 952-3809
Mailing address
1808 VERDUGO BLVD, #120, GLENDALE, CA 91208-1477
(818) 952-1124
(818) 952-3809
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
D3290
CA
Other
Enumeration date
05/30/2007
Last updated
07/08/2007
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