Provider Demographics
NPI:1982909289
Name:CALIFORNIA EYE CLINIC
Entity Type:Organization
Organization Name:CALIFORNIA EYE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTINER
Authorized Official - Prefix:DR
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:HWANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-855-9912
Mailing Address - Street 1:2723 CROW CANYON RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1583
Mailing Address - Country:US
Mailing Address - Phone:925-855-9912
Mailing Address - Fax:
Practice Address - Street 1:2723 CROW CANYON RD
Practice Address - Street 2:SUTIE 110
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1583
Practice Address - Country:US
Practice Address - Phone:925-855-9912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty