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General NPI Number Information
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NPI Number | 1043473390
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Entity Type | Organization
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Legal Business Name | LAKEWOOD EYE PHYSICIANS AND SURGEONS INC A MEDICAL GROUP
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Dates
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Enumeration Date | 07/08/2008
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Last Update Date | 03/03/2009
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Provider Practice Location Address
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Address Line | 3300 E SOUTH ST SUITE 107
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City | LONG BEACH
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State | CA
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Zip | 90805-4550
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Country | US
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Telephone | 562-531-2020
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Fax | 562-531-1142
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Provider Business Mailing Address
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Address Line | 3300 E SOUTH ST SUITE 105
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City | LONG BEACH
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State | CA
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Zip | 90805-4550
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Country | US
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Telephone | 562-531-2020
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Fax | 562-531-1142
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Authorized Official
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Title or Position | CREDENTIALING
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Name | MRS. CAROLINE BARRAGAN
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Credential |
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Telephone | 562-531-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State | CA
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