Provider Demographics
NPI:1952452450
Name:NORTH COUNTY LASER EYE ASSOCIATES, APC
Entity Type:Organization
Organization Name:NORTH COUNTY LASER EYE ASSOCIATES, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:HONG-DZE
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-930-9696
Mailing Address - Street 1:1905 CALLE BARCELONA
Mailing Address - Street 2:SUITE 208
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-8450
Mailing Address - Country:US
Mailing Address - Phone:760-930-9696
Mailing Address - Fax:760-930-0737
Practice Address - Street 1:1905 CALLE BARCELONA
Practice Address - Street 2:SUITE 208
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-8450
Practice Address - Country:US
Practice Address - Phone:760-930-9696
Practice Address - Fax:760-930-0737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-13
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12395T152W00000X
CAA65156207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW19332Medicare PIN