Healthcare Provider Details

I. General information

NPI: 1063969509
Provider Name (Legal Business Name): EYE SPECIALISTS OF CALIFORNIA MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 09/02/2020
Certification Date: 09/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1955 CITRACADO PKWY STE 301
ESCONDIDO CA
92029-4113
US

IV. Provider business mailing address

1955 CITRACADO PKWY STE 301
ESCONDIDO CA
92029-4113
US

V. Phone/Fax

Practice location:
  • Phone: 760-746-3937
  • Fax: 760-746-3991
Mailing address:
  • Phone: 760-746-3937
  • Fax: 760-746-3991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number179101
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA100361
License Number StateCA

VIII. Authorized Official

Name: DR. ARVIND SAINI
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 760-746-3937