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General NPI Number Information
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NPI Number | 1457062432
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Entity Type | Organization
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Legal Business Name | SURGICAL EYE EXPEDITIONS
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Dates
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Enumeration Date | 12/09/2022
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 295 PINE AVE
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City | GOLETA
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State | CA
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Zip | 93117-3713
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Country | US
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Telephone | 805-770-1376
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Fax |
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Provider Business Mailing Address
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Address Line | 6500 HOLLISTER AVE STE 120
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City | GOLETA
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State | CA
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Zip | 93117-5556
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Country | US
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Telephone | 805-770-1376
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT OF PROGRAMS
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Name | ARIANNA CASTELLANOS
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Credential |
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Telephone | 805-963-3303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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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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