Provider Demographics
NPI:1386678860
Name:MAJOR, DOUGLAS L (OD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:L
Last Name:MAJOR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 VINE ST
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-5505
Mailing Address - Country:US
Mailing Address - Phone:805-238-1001
Mailing Address - Fax:805-237-1057
Practice Address - Street 1:1112 VINE ST
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-5505
Practice Address - Country:US
Practice Address - Phone:805-238-1001
Practice Address - Fax:805-237-1057
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8275T152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3737OtherMESC
CACAP112960OtherCA CHILDRENS SERVICES
CAGSD001440Medicaid
CASD0062080Medicaid
CACAP112960OtherCA CHILDRENS SERVICES
CAT79337Medicare UPIN
CA0312300001Medicare NSC
CAWOP8275CMedicare PIN
CAGSD001440Medicaid