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General NPI Number Information
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NPI Number | 1932216157
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Entity Type | Organization
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Legal Business Name | SALL EYE RESEARCH MEDICAL CENTER
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 08/18/2011
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Provider Practice Location Address
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Address Line | 11423 187TH STREET SUITE 200
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City | ARTESIA
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State | CA
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Zip | 90701-5657
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Country | US
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Telephone | 562-804-1974
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Fax | 562-804-4350
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Provider Business Mailing Address
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Address Line | 11423 187TH STREET SUITE 200
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City | ARTESIA
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State | CA
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Zip | 90701-5657
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Country | US
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Telephone | 562-804-1974
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Fax | 562-804-4350
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Authorized Official
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Title or Position | MEDICAL DIRECTOR/OWNER
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Name | DR. KENNETH N SALL
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Credential | M.D.
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Telephone | 562-804-1974
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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 |
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