Healthcare Provider Details

I. General information

NPI: 1982913265
Provider Name (Legal Business Name): BRIGHT EYES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2010
Last Update Date: 02/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 WESTERN AVE SUITE 101
SAN BERNARDINO CA
92411-1356
US

IV. Provider business mailing address

7928 SIERRA VISTA ST
RANCHO CUCAMONGA CA
91730-1833
US

V. Phone/Fax

Practice location:
  • Phone: 909-887-3937
  • Fax:
Mailing address:
  • Phone: 909-271-2702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License NumberA98455
License Number StateCA

VIII. Authorized Official

Name: DR. CORINNA MIRIAM POKORNY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 909-271-2702