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Organization
INLAND EYE SPECIALISTS A MEDICAL CORP
Active
Organization
INLAND EYE SPECIALISTS A MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE NEAL (ASSISTANT SECRETARY)
(844) 377-6468
Entity
Organization
Contact information
Practice address
3953 W STETSON AVE, HEMET, CA 92545-9687
(951) 652-4343
(951) 266-5302
Mailing address
PO BOX 85426, LOS ANGELES, CA 90084-5426
(951) 652-4343
(951) 266-5302
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
NULL
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05C0001076
05C0001076 - CALIFORNIA - DME PTAN
CA
05
—
GR0044190
—
CA
05
—
GSD003100
—
CA
Enumeration date
08/03/2006
Last updated
03/12/2020
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