Provider Demographics
NPI:1538135694
Name:EYE PHYSICIANS MEDICAL SURGICAL CENTER
Entity Type:Organization
Organization Name:EYE PHYSICIANS MEDICAL SURGICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER MD
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-420-2111
Mailing Address - Street 1:681 THIRD AVENUE
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-5703
Mailing Address - Country:US
Mailing Address - Phone:619-420-2111
Mailing Address - Fax:619-585-8130
Practice Address - Street 1:681 THIRD AVENUE
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-5703
Practice Address - Country:US
Practice Address - Phone:619-420-2111
Practice Address - Fax:619-585-8130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0067510Medicaid
CA0500260001Medicare NSC
CAGR0067510Medicaid