Healthcare Provider Details

I. General information

NPI: 1437548708
Provider Name (Legal Business Name): UCI OPHTHALMOLOGY GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2015
Last Update Date: 01/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 THE CITY DR S
ORANGE CA
92868-3201
US

IV. Provider business mailing address

PO BOX 51055
LOS ANGELES CA
90051-5355
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-2986
  • Fax: 714-456-2979
Mailing address:
  • Phone: 714-456-2986
  • Fax: 714-456-2979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

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