Organization · NPI-2
Eyecare Specialists Medical Group, INC
Ophthalmology · Indio, CA
NPI number1750909065
StatusActive
Last updated in NPPESNov 28, 2022
Details
- NPI
- 1750909065
- Entity type
- Organization (NPI-2)
- Legal business name
- Eyecare Specialists Medical Group, INC
- Organization subpart
- No
- Enumeration date
- Jul 13, 2020
- Certification date
- Nov 28, 2022
- Last updated
- Nov 28, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207W00000X | Ophthalmology | – | – | Yes |
Other names
- Atlantis Eyecare (Doing Business As)
Practice location
81893 Dr Carreon Blvd Ste 101Indio, CA 92201-0604
Phone 760-396-3600 · Fax 760-396-5379
Mailing address
1595 E 17th StSanta Ana, CA 92705-8506
Phone 714-399-0678 · Fax 714-276-6489
Authorized official
Felisa Marisol Galindo
Credentialing Supervisor
6263059100
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