Provider Demographics
NPI:1326285073
Name:CALIFORNIA FACE AND LASER INSTITUTE
Entity Type:Organization
Organization Name:CALIFORNIA FACE AND LASER INSTITUTE
Other - Org Name:CALIFORNIA EAR INSTITUTE, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OFFICE DRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:INEZ
Authorized Official - Middle Name:C
Authorized Official - Last Name:WONDEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-617-2270
Mailing Address - Street 1:1900 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:E PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-2212
Mailing Address - Country:US
Mailing Address - Phone:650-462-1000
Mailing Address - Fax:650-617-2266
Practice Address - Street 1:1900 UNIVERSITY AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:E PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-2212
Practice Address - Country:US
Practice Address - Phone:650-462-1000
Practice Address - Fax:650-617-2266
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CALIFORNIA EAR INSTITUTE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-17
Last Update Date:2009-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical