Provider Demographics
NPI:1790730521
Name:HILARY L. HAWHORNE, O.D., AN OPTOMETRIC CORPORATION
Entity Type:Organization
Organization Name:HILARY L. HAWHORNE, O.D., AN OPTOMETRIC CORPORATION
Other - Org Name:COMMUNITY EYE CENTER OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HILARY
Authorized Official - Middle Name:LISA
Authorized Official - Last Name:HAWTHORNE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:323-778-7799
Mailing Address - Street 1:PO BOX 45792
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-0792
Mailing Address - Country:US
Mailing Address - Phone:323-778-7799
Mailing Address - Fax:323-752-1959
Practice Address - Street 1:953 W 85TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90044-4919
Practice Address - Country:US
Practice Address - Phone:323-778-7799
Practice Address - Fax:323-752-1959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10080 TPL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0686OtherGOLDEN WEST HEALTH PLAN
CA43-39OtherAVESIS
CA3987OtherFHP
CA705479OtherPACIFIC CARE CAMBRIDGE
CA10080OtherFOUNDATION HEALTH
CASD0100800Medicaid
CA115406OtherEYE CARE PLAN OF AMERICA
CA35493OtherDAVIS VISION
CA4439OtherCARE 1ST HEALTH PLAN
CA13119OtherVISION BENEFITS OF AMERIC
CAE335OtherEYE CARE ADMINISTRATORS
CAE335OtherEYE CARE ADMINISTRATORS
CAMH654916OtherDEA
CA43-39OtherAVESIS