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General NPI Number Information
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NPI Number | 1871783019
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Entity Type | Organization
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Legal Business Name | CENTURY EYE CARE MEDICAL CENTER, INC.
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 12/31/2025
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Provider Practice Location Address
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Address Line | 1141 W REDONDO BEACH BLVD STE 101
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City | GARDENA
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State | CA
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Zip | 90247-3585
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Country | US
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Telephone | 310-767-7814
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Fax | 310-323-3785
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Provider Business Mailing Address
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Address Line | 1141 W REDONDO BEACH BLVD STE 101
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City | GARDENA
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State | CA
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Zip | 90247-3585
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Country | US
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Telephone | 310-767-7814
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Fax | 310-323-3785
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Authorized Official
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Title or Position | FINANCE EXECUTIVE ADMINISTRATOR
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Name | CYNTHIA GASCON
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Credential |
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Telephone | 310-767-7814
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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 | G83156
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License Number State | CA
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