Healthcare Provider Details

I. General information

NPI: 1518132596
Provider Name (Legal Business Name): OCULAR INSTITUTE OF CALIFORNIA, A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2008
Last Update Date: 04/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17833 COLIMA RD
CITY OF INDUSTRY CA
91748-1729
US

IV. Provider business mailing address

PO BOX 708
ROSEMEAD CA
91770-0708
US

V. Phone/Fax

Practice location:
  • Phone: 626-964-8864
  • Fax:
Mailing address:
  • Phone: 626-485-4007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA62421
License Number StateCA

VIII. Authorized Official

Name: DR. STEVEN SHUOH-TYNG MA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 626-485-4007