Provider Demographics
NPI:1932123965
Name:HOLLAND, GARY NORMAN (MD)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:NORMAN
Last Name:HOLLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:JULES STEIN EYE INSTITUTE
Mailing Address - Street 2:100 STEIN PLAZA, UCLA
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-7003
Mailing Address - Country:US
Mailing Address - Phone:310-206-7202
Mailing Address - Fax:310-794-7906
Practice Address - Street 1:JULES STEIN EYE INSTITUTE
Practice Address - Street 2:100 STEIN PLAZA, UCLA
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-7003
Practice Address - Country:US
Practice Address - Phone:310-206-7202
Practice Address - Fax:310-794-7906
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG43637207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G436370Medicaid
CA00G436370Medicaid
CAWG43637AMedicare PIN