Healthcare Provider Details

I. General information

NPI: 1891865770
Provider Name (Legal Business Name): OCULAR PROSTHETICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 N LARCHMONT BLVD SUITE 711
LOS ANGELES CA
90004-3025
US

IV. Provider business mailing address

321 N LARCHMONT BLVD SUITE 711
LOS ANGELES CA
90004-3025
US

V. Phone/Fax

Practice location:
  • Phone: 323-462-6004
  • Fax:
Mailing address:
  • Phone: 323-462-6004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN EDWARD HADDAD
Title or Position: PRESIDENT
Credential:
Phone: 323-462-6004