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Organization
DE LA PENA EYE CLINIC, A MEDICAL GROUP, INC
Active
Organization
DE LA PENA EYE CLINIC, A MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK KELLY (MEMBER, BOARD OF MANAGERS)
(615) 760-6593
Entity
Organization
Contact information
Practice address
7749 PAINTER AVE, WHITTIER, CA 90602-2411
(323) 728-5500
Mailing address
401 COMMERCE ST STE 600, NASHVILLE, TN 37219-2518
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
05/26/2020
Last updated
05/26/2020
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