Provider Demographics
NPI:1760798078
Name:CALIFORNIA EYE CARE MANAGED EYE CARE SPECIALISTS A MEDICAL GROUP INC.
Entity Type:Organization
Organization Name:CALIFORNIA EYE CARE MANAGED EYE CARE SPECIALISTS A MEDICAL GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEMLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-871-7520
Mailing Address - Street 1:480 APOLLO ST
Mailing Address - Street 2:STE C
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821
Mailing Address - Country:US
Mailing Address - Phone:714-871-7520
Mailing Address - Fax:714-529-2923
Practice Address - Street 1:480 APOLLO ST
Practice Address - Street 2:STE C
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821
Practice Address - Country:US
Practice Address - Phone:714-871-7520
Practice Address - Fax:714-529-2923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-24
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty