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General NPI Number Information
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NPI Number | 1679528947
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Entity Type | Organization
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Legal Business Name | DOUGLAS R. MYERS, O.D., INC.
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 119 YELLOWSTONE DR
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City | CHICO
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State | CA
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Zip | 95973-5811
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Country | US
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Telephone | 530-891-1146
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Fax | 530-891-0123
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Provider Business Mailing Address
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Address Line | 119 YELLOWSTONE DR
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City | CHICO
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State | CA
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Zip | 95973-5811
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Country | US
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Telephone | 530-891-1146
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Fax | 530-891-0123
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Authorized Official
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Title or Position | OPTOMETRIST / CEO
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Name | DOUGLAS RICHARD MYERS
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Credential | O.D.
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Telephone | 530-891-1146
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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 | 9963 T
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5438 T
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License Number State | CA
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