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General NPI Number Information
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NPI Number | 1932111473
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Entity Type | Organization
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Legal Business Name | PRECISION EYE CARE, A MEDICAL CORP CLINIC
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 09/10/2015
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Provider Practice Location Address
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Address Line | 655 EUCLID AVE SUITE 302
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City | NATIONAL CITY
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State | CA
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Zip | 91950-2957
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Country | US
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Telephone | 619-472-1010
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Fax | 619-472-2092
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Provider Business Mailing Address
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Address Line | PO BOX 81187
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City | SAN DIEGO
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State | CA
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Zip | 92138-1187
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Country | US
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Telephone | 619-472-1010
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Fax | 619-472-2092
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Authorized Official
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Title or Position | PROPRIETOR
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Name | GORDON JAMES MONTGOMERY
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Credential | M.D.
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Telephone | 619-472-1010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G31591
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License Number State | CA
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