Provider Demographics
NPI:1952468878
Name:GARBUS, CARL (OD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:
Last Name:GARBUS
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 1:28089 SMYTH DR
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-4023
Mailing Address - Country:US
Mailing Address - Phone:661-775-1860
Mailing Address - Fax:661-775-9627
Practice Address - Street 1:28089 SMYTH DR
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-4023
Practice Address - Country:US
Practice Address - Phone:661-775-1860
Practice Address - Fax:661-775-9627
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6925T152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT70156Medicare UPIN
CAWOP6925DMedicare PIN