Healthcare Provider Details

I. General information

NPI: 1104251222
Provider Name (Legal Business Name): GAVIN HERBERT EYE INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2013
Last Update Date: 09/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 HEALTH SCIENCES RD
IRVINE CA
92697-0001
US

IV. Provider business mailing address

850 HEALTH SCIENCES RD
IRVINE CA
92697-0001
US

V. Phone/Fax

Practice location:
  • Phone: 949-824-2020
  • Fax: 949-824-2073
Mailing address:
  • Phone: 949-824-2020
  • Fax: 949-824-2073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. ROGER F. STEINERT
Title or Position: DIRECTOR
Credential: M.D.
Phone: 949-824-2020