Provider Demographics
NPI:1346695863
Name:JULES STEIN EYE INSTITUTE MEDICAL GROUP
Entity Type:Organization
Organization Name:JULES STEIN EYE INSTITUTE MEDICAL GROUP
Other - Org Name:DOHENY EYE CENTER UCLA - PASADENA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BARTLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MONDINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-817-4747
Mailing Address - Street 1:5767 W CENTURY BLVD
Mailing Address - Street 2:STE 400
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:310-301-8707
Mailing Address - Fax:310-301-8751
Practice Address - Street 1:625 S FAIR OAKS AVE
Practice Address - Street 2:SUITE 280
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2613
Practice Address - Country:US
Practice Address - Phone:626-817-4747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-03
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies