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General NPI Number Information
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NPI Number | 1700030053
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Entity Type | Organization
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Legal Business Name | MOTWANI LASIK INSTITUTE
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Dates
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Enumeration Date | 11/13/2008
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Last Update Date | 12/22/2010
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Provider Practice Location Address
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Address Line | 4520 EXECUTIVE DR SUITE #230
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City | SAN DIEGO
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State | CA
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Zip | 92121-3018
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Country | US
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Telephone | 858-554-0008
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Fax | 858-554-1860
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Provider Business Mailing Address
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Address Line | 4520 EXECUTIVE DRIVE SUITE #230
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City | SAN DIEGO
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State | CA
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Zip | 92121-3018
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Country | US
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Telephone | 858-554-0008
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Fax | 858-554-1860
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MANOJ V MOTWANI
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Credential | M.D.
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Telephone | 858-554-0008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | A69391
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License Number State | CA
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