| NPI | 1306069653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLE ANN CASTEEN Owner 661-663-9090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G50991) |
| 208600000X Surgery (Licence: CA G50991) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA 0584260001) | |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2018-08-08 |