Provider Demographics
NPI:1518642362
Name:CLOE
Entity Type:Organization
Organization Name:CLOE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PIRAKITIKULR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-500-5851
Mailing Address - Street 1:531 N HIGHWAY 101
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-1132
Mailing Address - Country:US
Mailing Address - Phone:858-500-5851
Mailing Address - Fax:858-529-9953
Practice Address - Street 1:531 N HIGHWAY 101
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-1132
Practice Address - Country:US
Practice Address - Phone:858-500-5851
Practice Address - Fax:858-529-9953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-20
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive SurgeryGroup - Single Specialty