Provider Demographics
NPI:1821291691
Name:EVE, IRWIN
Entity Type:Individual
Prefix:
First Name:IRWIN
Middle Name:
Last Name:EVE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1046 COAST VILLAGE RD
Mailing Address - Street 2:
Mailing Address - City:MONTECITO
Mailing Address - State:CA
Mailing Address - Zip Code:93108-2732
Mailing Address - Country:US
Mailing Address - Phone:805-565-3415
Mailing Address - Fax:805-565-1435
Practice Address - Street 1:1046 COAST VILLAGE RD
Practice Address - Street 2:
Practice Address - City:MONTECITO
Practice Address - State:CA
Practice Address - Zip Code:93108-2732
Practice Address - Country:US
Practice Address - Phone:805-565-3415
Practice Address - Fax:805-565-1435
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA010321156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician