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General NPI Number Information
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NPI Number | 1558510834
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Entity Type | Organization
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Legal Business Name | DARIN EYE CENTER A MEDICAL
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Dates
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Enumeration Date | 09/11/2008
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Last Update Date | 08/22/2023
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Provider Practice Location Address
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Address Line | 696 HAMPSHIRE RD STE 120
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361-4457
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Country | US
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Telephone | 818-787-2020
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Fax | 818-787-8652
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Provider Business Mailing Address
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Address Line | 696 HAMPSHIRE ROAD SUITE 120
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361
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Country | US
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Telephone | 805-778-1034
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Fax | 805-778-9194
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | EDWARD CHUNG
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Credential |
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Telephone | 818-275-0009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | G044103
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | W20551
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License Number State | CA
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