Provider Demographics
NPI:1942577937
Name:PRESBYTERIAN HEALTH PHYSICIANS
Entity Type:Organization
Organization Name:PRESBYTERIAN HEALTH PHYSICIANS
Other - Org Name:BRIGHT HEALTH PHYSICIANS EYE CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF BUSINESS SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:DILLARD-BETHEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-789-5401
Mailing Address - Street 1:PO BOX 1277
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90609-1277
Mailing Address - Country:US
Mailing Address - Phone:562-789-5401
Mailing Address - Fax:
Practice Address - Street 1:301 W BASTANCHURY
Practice Address - Street 2:SUITE 140
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3427
Practice Address - Country:US
Practice Address - Phone:562-694-2500
Practice Address - Fax:562-694-2577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-19
Last Update Date:2011-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83764207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty