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General NPI Number Information
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NPI Number | 1972982114
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Entity Type | Organization
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Legal Business Name | CMMP CLINICA DE OJOS
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Dates
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Enumeration Date | 05/20/2015
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Last Update Date | 05/20/2015
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Provider Practice Location Address
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Address Line | 2007 WILSHIRE BLVD SUITE 522
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City | LOS ANGELES
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State | CA
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Zip | 90057-3506
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Country | US
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Telephone | 213-805-6005
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Fax | 213-805-6001
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Provider Business Mailing Address
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Address Line | 2007 WILSHIRE BLVD SUITE 522
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City | LOS ANGELES
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State | CA
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Zip | 90057-3506
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Country | US
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Telephone | 213-805-6005
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Fax | 213-805-6001
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. CARLOS FRANCISCO MONTOYA SR.
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Credential | M.D.
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Telephone | 714-393-8809
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number | A40547
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License Number State | CA
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