Provider Demographics
NPI:1821088659
Name:WILLIAMS, DOUGLAS ROBERT (OD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:ROBERT
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:6042 WARNER AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-5568
Mailing Address - Country:US
Mailing Address - Phone:714-847-6059
Mailing Address - Fax:714-847-6050
Practice Address - Street 1:6042 WARNER AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-5568
Practice Address - Country:US
Practice Address - Phone:714-847-6059
Practice Address - Fax:714-847-6050
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAOP4927152W00000X, 152WC0802X, 152WL0500X, 152WP0200X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision