Healthcare Provider Details

I. General information

NPI: 1922164433
Provider Name (Legal Business Name): OCULAR INSTITUTE OF CALIFORNIA, A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 02/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9428 VALLEY BLVD. STE 201
ROSEMEAD CA
91770-1514
US

IV. Provider business mailing address

PO BOX 708
ROSEMEAD CA
91770-0708
US

V. Phone/Fax

Practice location:
  • Phone: 626-350-6776
  • Fax: 626-350-3353
Mailing address:
  • Phone: 626-485-4007
  • Fax: 626-226-4024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA62421
License Number StateCA

VIII. Authorized Official

Name: DR. STEVEN SHUOH-TYNG MA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 626-485-4007