# DOHENY EYE MEDICAL GROUP, INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1225194194
- **Authorized official:** RONALD E SMITH M.D. (CHAIRMAN)
- **Authorized official phone:** (323) 442-6425

## Contact information

- **Practice address:** 40055 BOB HOPE DR, SUITE J, RANCHO MIRAGE, CA 92270-3937
- **Practice address phone:** (760) 320-2133
- **Practice address fax:** (760) 327-0495
- **Mailing address:** 1450 SAN PABLO ST, SUITE 3700, LOS ANGELES, CA 90033-4500
- **Mailing address phone:** (323) 442-7152
- **Mailing address fax:** (323) 442-7166

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |
| 261Q00000X | Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 12/28/2006
- **Last updated:** 02/27/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GR0059892 | — | CA |
| 01 | — | ZZZ51610Z | BLUE SHIELD | CA |