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General NPI Number Information
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NPI Number | 1790972693
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Entity Type | Organization
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Legal Business Name | OCULAR SURGERY MEDICAL ASSOCIATES
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Dates
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Enumeration Date | 09/25/2007
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Last Update Date | 10/21/2011
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Provider Practice Location Address
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Address Line | 1245 WILSHIRE BLVD STE 801
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City | LOS ANGELES
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State | CA
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Zip | 90017-4808
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Country | US
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Telephone | 213-977-1184
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Fax |
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Provider Business Mailing Address
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Address Line | 1245 WILSHIRE BLVD STE 801
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City | LOS ANGELES
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State | CA
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Zip | 90017-4808
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | NICOLE ROSENE
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Credential |
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Telephone | 818-706-9191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1100X
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Taxonomy Name | Ophthalmic Technician/Technologist
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License Number |
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License Number State |
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