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General NPI Number Information
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NPI Number | 1992746382
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Entity Type | Organization
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Legal Business Name | MIRAMAR EYE SPECIALISTS MEDICAL GROUP, INC
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 3085 LOMA VISTA RD
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City | VENTURA
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State | CA
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Zip | 93003-2916
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Country | US
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Telephone | 805-648-3085
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Fax | 805-648-7027
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Provider Business Mailing Address
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Address Line | 3085 LOMA VISTA RD
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City | VENTURA
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State | CA
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Zip | 93003-2916
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Country | US
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Telephone | 805-648-3085
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Fax | 805-648-7027
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Authorized Official
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Title or Position | PRESIDENT/MEDICAL DIRECTOR
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Name | DR. JOEL CORWIN
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Credential |
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Telephone | 805-583-3950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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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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