Provider Demographics
NPI:1700030053
Name:MOTWANI LASIK INSTITUTE
Entity Type:Organization
Organization Name:MOTWANI LASIK INSTITUTE
Other - Org Name:CLARUS MEDICAL, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MANOJ
Authorized Official - Middle Name:V
Authorized Official - Last Name:MOTWANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-554-0008
Mailing Address - Street 1:4520 EXECUTIVE DRIVE
Mailing Address - Street 2:SUITE #230
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-3018
Mailing Address - Country:US
Mailing Address - Phone:858-554-0008
Mailing Address - Fax:858-554-1860
Practice Address - Street 1:4520 EXECUTIVE DR
Practice Address - Street 2:SUITE #230
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-3018
Practice Address - Country:US
Practice Address - Phone:858-554-0008
Practice Address - Fax:858-554-1860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-13
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA69391207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA676288Medicare UPIN