| NPI | 1285247528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWAYNE KEITH LOGAN Md/CEO 714-399-0678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| 207WX0009X Ophthalmology Glaucoma Specialist | |
| 207WX0107X Ophthalmology Retina Specialist | |
| 207WX0120X Ophthalmology Cornea and External Diseases Specialist | |
| 207WX0200X Ophthalmology Ophthalmic Plastic and Reconstructive Surgery | |
| Enumeration Date | 2020-08-26 |
| Last Update Date | 2025-01-27 |