Healthcare Provider Details

I. General information

NPI: 1427155662
Provider Name (Legal Business Name): SOCAL FAMILY EYE CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 03/14/2024
Certification Date: 03/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 ATLANTIC AVE
LONG BEACH CA
90807-3418
US

IV. Provider business mailing address

3650 ATLANTIC AVE
LONG BEACH CA
90807-3418
US

V. Phone/Fax

Practice location:
  • Phone: 562-988-2020
  • Fax: 562-426-7394
Mailing address:
  • Phone: 562-988-2020
  • Fax: 562-426-7394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberG54415
License Number StateCA

VIII. Authorized Official

Name: HARSHAD P PATEL
Title or Position: PHYSICIAN
Credential: MD
Phone: 562-988-2020