Provider Demographics
NPI:1528409216
Name:QUANTUM EYE GROUP, INC.
Entity Type:Organization
Organization Name:QUANTUM EYE GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:MENGHANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MBA
Authorized Official - Phone:562-297-0880
Mailing Address - Street 1:1945 PALO VERDE AVE
Mailing Address - Street 2:SUITE #210
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-3445
Mailing Address - Country:US
Mailing Address - Phone:562-297-0880
Mailing Address - Fax:877-205-9923
Practice Address - Street 1:1945 PALO VERDE AVE
Practice Address - Street 2:SUITE #210
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-3445
Practice Address - Country:US
Practice Address - Phone:562-297-0880
Practice Address - Fax:877-205-9923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-10
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA115755207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty