Provider Demographics
NPI:1710756424
Name:GHIAM EYE PC
Entity Type:Organization
Organization Name:GHIAM EYE PC
Other - Org Name:GHIAM EYE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:KAMBIZ
Authorized Official - Last Name:GHIAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-625-8552
Mailing Address - Street 1:2222 AVENUE OF THE STARS UNIT 904
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067-5657
Mailing Address - Country:US
Mailing Address - Phone:818-625-8552
Mailing Address - Fax:
Practice Address - Street 1:23318 PARK COLOMBO
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-2810
Practice Address - Country:US
Practice Address - Phone:818-625-8552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-21
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0109XAllopathic & Osteopathic PhysiciansOphthalmologyNeuro-ophthalmologyGroup - Single Specialty