Provider Demographics
NPI:1972982114
Name:CMMP CLINICA DE OJOS
Entity Type:Organization
Organization Name:CMMP CLINICA DE OJOS
Other - Org Name:CMMP CLINICA DE OJOS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:FRANCISCO
Authorized Official - Last Name:MONTOYA
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:714-393-8809
Mailing Address - Street 1:2007 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 522
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-3506
Mailing Address - Country:US
Mailing Address - Phone:213-805-6005
Mailing Address - Fax:213-805-6001
Practice Address - Street 1:2007 WILSHIRE BLVD
Practice Address - Street 2:SUITE 522
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-3506
Practice Address - Country:US
Practice Address - Phone:213-805-6005
Practice Address - Fax:213-805-6001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-20
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40547261QS0132X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery