Healthcare Provider Details

I. General information

NPI: 1164168431
Provider Name (Legal Business Name): EAST-WEST EYE INSTITUTE A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2022
Last Update Date: 05/10/2022
Certification Date: 04/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23000 CRENSHAW BLVD STE 100
TORRANCE CA
90505-3052
US

IV. Provider business mailing address

420 E 3RD ST STE 603
LOS ANGELES CA
90013-1645
US

V. Phone/Fax

Practice location:
  • Phone: 714-901-2006
  • Fax:
Mailing address:
  • Phone: 213-625-2694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: ALEX CHUNHSIEN LIU
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 310-791-2233