Provider Demographics
NPI:1356473136
Name:CALIFORNIA LASER EYE ASSOCIATES
Entity Type:Organization
Organization Name:CALIFORNIA LASER EYE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINS
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAT
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-629-4051
Mailing Address - Street 1:160 E ARTESIA ST
Mailing Address - Street 2:ST 325
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-2900
Mailing Address - Country:US
Mailing Address - Phone:909-629-4051
Mailing Address - Fax:909-629-9110
Practice Address - Street 1:160 E ARTESIA ST
Practice Address - Street 2:ST 325
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-2900
Practice Address - Country:US
Practice Address - Phone:909-629-4051
Practice Address - Fax:909-629-9110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty