Provider Demographics
NPI:1962715961
Name:AASEBY, DOUGLAS H (OD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:H
Last Name:AASEBY
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Gender:M
Credentials:OD
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Mailing Address - Street 1:3840 EL DORADO HILLS BLVD
Mailing Address - Street 2:#103
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-4567
Mailing Address - Country:US
Mailing Address - Phone:919-939-4470
Mailing Address - Fax:916-939-8870
Practice Address - Street 1:3840 EL DORADO HILLS BLVD
Practice Address - Street 2:#103
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-4567
Practice Address - Country:US
Practice Address - Phone:916-939-4470
Practice Address - Fax:916-939-8870
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-19
Last Update Date:2012-11-19
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Provider Licenses
StateLicense IDTaxonomies
CAOPT6856T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFG148AMedicare PIN