=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528943925
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JULES STEIN EYE INSTITUTE MEDICAL GROUP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/06/2025
-----------------------------------------------------
Last Update Date | 08/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 150 N ORANGE GROVE BLVD STE 1400
-----------------------------------------------------
City | PASADENA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91103-3534
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-817-4747
-----------------------------------------------------
Fax | 626-817-4748
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | FILE 2939
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90074-2939
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-301-8750
-----------------------------------------------------
Fax | 310-301-8751
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF ACCOUNTING
-----------------------------------------------------
Name | KATHERINE HALE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 310-301-5311
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------