Retina Consultants San Diego INC
Ophthalmology in Poway, CA. Organization (NPI-2).
NPI number1790736098
StatusActive
Last updated in NPPESFeb 6, 2024
Details
- NPI
- 1790736098
- Entity type
- Organization (NPI-2)
- Legal business name
- Retina Consultants San Diego INC
- Organization subpart
- No
- Enumeration date
- May 12, 2006
- Certification date
- Feb 6, 2024
- Last updated
- Feb 6, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207W00000X | Ophthalmology | – | – | Yes |
Other names
- Retina Consultants San Diego INC (Doing Business As)
Practice location
12630 Monte Vista RdSuite 104
Poway, CA 92064-2526
Phone 858-451-1911 · Fax 858-451-0566
Mailing address
12630 Monte Vista RdSuite 104
Poway, CA 92064-2526
Phone 858-451-1911 · Fax 858-451-0566
Authorized official
Jocelin Ing
Practice Administrator
8585007815
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