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General NPI Number Information
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NPI Number | 1023208402
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Entity Type | Organization
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Legal Business Name | NUVISION LASER MEDICAL ASSOCIATES, INC.
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Dates
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Enumeration Date | 07/31/2007
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Last Update Date | 07/14/2015
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Provider Practice Location Address
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Address Line | 7 W FOOTHILL BLVD SUITE 3
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City | ARCADIA
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State | CA
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Zip | 91006-2367
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Country | US
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Telephone | 773-359-3334
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Fax | 626-357-9020
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Provider Business Mailing Address
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Address Line | 7 W FOOTHILL BLVD SUITE 3
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City | ARCADIA
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State | CA
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Zip | 91006-2367
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Country | US
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Telephone | 773-359-3334
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Fax | 626-357-9020
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Authorized Official
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Title or Position | OWNER
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Name | DR. LORI DARLENE MOORE
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Credential | M.D.
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Telephone | 626-357-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | G57630
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License Number State | CA
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