Healthcare Provider Details

I. General information

NPI: 1245606698
Provider Name (Legal Business Name): VISION INSTITUTE OF SOUTHERN CALIFORNIA A PROFESSIONAL MEDICAL CORPORA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2015
Last Update Date: 02/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8341 WESTMINSTER BLVD., STE. 202
WESTMINSTER CA
92683
US

IV. Provider business mailing address

18725 GALE AVENUE SUITE 140
CITY OF INDUSTRY CA
91748
US

V. Phone/Fax

Practice location:
  • Phone: 714-230-8220
  • Fax: 714-230-8221
Mailing address:
  • Phone: 626-854-2020
  • Fax: 626-854-2021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ROBERT LIN
Title or Position: MEDICAL DIRECTOR/EYE SURGEON
Credential: M.D.
Phone: 626-854-2020