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General NPI Number Information
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NPI Number | 1245211465
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Entity Type | Individual
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Provider Name | DOUGLAS CLAYTON REBER O.D.
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Gender | Male
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Dates
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Enumeration Date | 11/07/2005
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Last Update Date | 01/05/2012
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Provider Practice Location Address
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Address Line | 525 ROBERTS LN OILDALE COMM HEALTH CENTER, OPTOMETRY
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City | BAKERSFIELD
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State | CA
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Zip | 93308-4799
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Country | US
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Telephone | 661-392-7850
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Fax | 661-399-2819
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Provider Business Mailing Address
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Address Line | 525 ROBERTS LN OILDALE COMM HEALTH CENTER, OPTOMETRY
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City | BAKERSFIELD
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State | CA
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Zip | 93308-4799
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Country | US
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Telephone | 661-392-7850
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Fax | 661-399-2819
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 9549 TPA
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License Number State | CA
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