Provider Demographics
NPI:1417442500
Name:LASER EYE CENTER INC
Entity Type:Organization
Organization Name:LASER EYE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAMMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-250-8888
Mailing Address - Street 1:1127 WILSHIRE BLVD STE 1216
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-4003
Mailing Address - Country:US
Mailing Address - Phone:213-223-0130
Mailing Address - Fax:213-223-0153
Practice Address - Street 1:1127 WILSHIRE BLVD STE 1209
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-4003
Practice Address - Country:US
Practice Address - Phone:213-250-8888
Practice Address - Fax:213-250-7910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-29
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty