Provider Demographics
NPI:1497083190
Name:PUENTE HILLS EYE CARE CENTER, INC.
Entity Type:Organization
Organization Name:PUENTE HILLS EYE CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GARLAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:LO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-912-6888
Mailing Address - Street 1:1850 S AZUSA AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-6813
Mailing Address - Country:US
Mailing Address - Phone:626-912-6888
Mailing Address - Fax:626-913-9281
Practice Address - Street 1:1850 S AZUSA AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-6813
Practice Address - Country:US
Practice Address - Phone:626-912-6888
Practice Address - Fax:626-913-9281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-18
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty