Organization Active NPI

Donald E. Teagle, OD

  • Optometrist
  • Glendale, CA
National Provider Identifier
1740453935
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9454T Issued in CA
Legal business name
DONALD E. TEAGLE, OD
Practice address
1321 Glendale Galleria
Glendale, CA 91210-1400
Phone
(818) 956-0873
Fax
(818) 956-7015
NPI assigned
Apr 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Donald Edward Teagle, ODNPI 1700931706
Title
Owner
Phone
(818) 956-0873

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 9454T CA Primary

Addresses

Primary practice location

1321 Glendale Galleria
Glendale, CA 91210-1400

Mailing address

1321 Glendale Galleria
Glendale, CA 91210-1400
Phone (818) 956-0873

Other identifiers 1

IdentifierTypeStateIssuer
GSD005100MedicaidCA

National Provider Directory

National Provider Directory

Locations

1321 Glendale Galleria
Glendale, CA 91210
Phone (818) 956-0873

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1740453935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 GLENDALE GALLERIA",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912101400",
            "telephone_number": "818-956-0873",
            "fax_number": "818-956-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 GLENDALE GALLERIA",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912101400",
            "telephone_number": "818-956-0873",
            "fax_number": "818-956-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONALD E. TEAGLE, OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "TEAGLE",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-956-0873",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9454T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD005100",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.