Provider Demographics
NPI:1912904046
Name:MIGDAL, TERRY C (OD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:C
Last Name:MIGDAL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24881 ALICIA PKWY
Mailing Address - Street 2:# E516
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-4617
Mailing Address - Country:US
Mailing Address - Phone:949-716-8613
Mailing Address - Fax:
Practice Address - Street 1:24982 HON AVE
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-4302
Practice Address - Country:US
Practice Address - Phone:949-716-8613
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7013T152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation