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General NPI Number Information
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NPI Number | 1881011567
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Entity Type | Organization
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Legal Business Name | JULES STEIN EYE INSTITUTE MEDICAL GROUP
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Dates
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Enumeration Date | 03/19/2014
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Last Update Date | 07/12/2024
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Provider Practice Location Address
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Address Line | 200 STEIN PLAZA SUITE 2-525
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City | LOS ANGELES
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State | CA
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Zip | 90095-0001
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Country | US
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Telephone | 310-825-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 5767 W CENTURY BLVD SUITE 400
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City | LOS ANGELES
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State | CA
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Zip | 90045-5631
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Country | US
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Telephone | 310-825-3090
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Fax |
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Authorized Official
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Title or Position | MD
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Name | VIVIAN SHIBAYAMA
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Credential | MD
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Telephone | 310-825-5000
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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 |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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