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General NPI Number Information
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NPI Number | 1134159148
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Entity Type | Organization
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Legal Business Name | DOHENY EYE MEDICAL GROUP
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 02/26/2008
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Provider Practice Location Address
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Address Line | 1450 SAN PABLO ST SUITE 4000
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City | LOS ANGELES
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State | CA
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Zip | 90033-4500
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Country | US
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Telephone | 323-442-7155
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Fax | 323-442-7158
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Provider Business Mailing Address
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Address Line | 1450 SAN PABLO ST SUITE 3700
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City | LOS ANGELES
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State | CA
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Zip | 90033-4500
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Country | US
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Telephone | 323-442-7155
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Fax | 323-442-7158
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RONALD E SMITH
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Credential | M.D.
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Telephone | 323-442-6425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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