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General NPI Number Information
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NPI Number | 1235463472
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Entity Type | Organization
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Legal Business Name | LASER EYE ASSOCIATES, INC.
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Dates
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Enumeration Date | 09/21/2009
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Last Update Date | 09/21/2009
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Provider Practice Location Address
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Address Line | 240 S LA CIENEGA BLVD SUITE 200
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-3324
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Country | US
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Telephone | 310-289-5992
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Fax | 310-289-5967
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Provider Business Mailing Address
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Address Line | 240 S LA CIENEGA BLVD SUITE 200
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-3324
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Country | US
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Telephone | 310-289-5992
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Fax | 310-289-5967
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES SALZ
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Credential | MD
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Telephone | 310-289-5992
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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 | 2421475
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License Number State | CA
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