Provider Demographics
NPI:1285179283
Name:EYE SPECIALISTS OF CALIFORNIA MEDICAL GROUP
Entity Type:Organization
Organization Name:EYE SPECIALISTS OF CALIFORNIA MEDICAL GROUP
Other - Org Name:ESCONDIDO OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARVIND
Authorized Official - Middle Name:
Authorized Official - Last Name:SAINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-746-3937
Mailing Address - Street 1:1955 CITRACADO PKWY STE 301
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-4113
Mailing Address - Country:US
Mailing Address - Phone:760-746-8308
Mailing Address - Fax:760-746-3991
Practice Address - Street 1:1955 CITRACADO PKWY STE 301
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92029
Practice Address - Country:US
Practice Address - Phone:760-746-8308
Practice Address - Fax:760-746-3991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-29
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207W00000X, 332H00000X
CA179101332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty