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General NPI Number Information
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NPI Number | 1982913265
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Entity Type | Organization
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Legal Business Name | BRIGHT EYES INC
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Dates
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Enumeration Date | 10/04/2010
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Last Update Date | 02/03/2011
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Provider Practice Location Address
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Address Line | 1800 WESTERN AVE SUITE 101
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City | SAN BERNARDINO
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State | CA
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Zip | 92411-1356
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Country | US
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Telephone | 909-887-3937
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Fax |
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Provider Business Mailing Address
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Address Line | 7928 SIERRA VISTA ST
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-1833
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Country | US
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Telephone | 909-271-2702
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CORINNA MIRIAM POKORNY
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Credential | M.D.
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Telephone | 909-271-2702
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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 | A98455
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License Number State | CA
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