Provider Demographics
NPI:1265645717
Name:LASER EYE CARE OF CALIFORNIA, LLC
Entity Type:Organization
Organization Name:LASER EYE CARE OF CALIFORNIA, LLC
Other - Org Name:TLC LASER EYE CENTERS ENCINO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:ANDREW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-534-2300
Mailing Address - Street 1:16305 SWINGLEY RIDGE RD
Mailing Address - Street 2:STE. 300
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-1777
Mailing Address - Country:US
Mailing Address - Phone:636-534-2300
Mailing Address - Fax:
Practice Address - Street 1:16255 VENTURA BLVD
Practice Address - Street 2:STE. 100
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2302
Practice Address - Country:US
Practice Address - Phone:818-718-2010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center