Healthcare Provider Details
I. General information
NPI: 1255472841
Provider Name (Legal Business Name): LYNN EYE SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/08/2007
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2230 LYNN RD STE 106
THOUSAND OAKS CA
91360-1972
US
IV. Provider business mailing address
75 ENTERPRISE
ALISO VIEJO CA
92656-2629
US
V. Phone/Fax
- Phone: 805-370-3137
- Fax: 805-370-3242
- Phone: 877-455-9942
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOEL
MICHAEL
CORWIN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 805-370-3137