Healthcare Provider Details

I. General information

NPI: 1346356987
Provider Name (Legal Business Name): MAGNOLIA EYE CARE MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 09/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14571 MAGNOLIA ST #205
WESTMINSTER CA
92683-5574
US

IV. Provider business mailing address

14571 MAGNOLIA ST #205
WESTMINSTER CA
92683-5574
US

V. Phone/Fax

Practice location:
  • Phone: 714-894-4599
  • Fax: 714-897-7367
Mailing address:
  • Phone: 714-894-4599
  • Fax: 714-897-7367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. ARTHUR LU
Title or Position: OFFICE MANAGER
Credential:
Phone: 714-894-4599