# INLAND EYE SPECIALISTS A MEDICAL CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083622567
- **Authorized official:** MR. GEORGE NEAL (ASSISTANT SECRETARY)
- **Authorized official phone:** (844) 377-6468

## Contact information

- **Practice address:** 3953 W STETSON AVE, HEMET, CA 92545-9687
- **Practice address phone:** (951) 652-4343
- **Practice address fax:** (951) 266-5302
- **Mailing address:** PO BOX 85426, LOS ANGELES, CA 90084-5426
- **Mailing address phone:** (951) 652-4343
- **Mailing address fax:** (951) 266-5302

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/03/2006
- **Last updated:** 03/12/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 05C0001076 | 05C0001076 - CALIFORNIA - DME PTAN | CA |
| 05 | — | GR0044190 | — | CA |
| 05 | — | GSD003100 | — | CA |