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Organization
EYE PHYSICIANS OF LONG BEACH A MEDICAL GROUP INC.
Active
Organization
EYE PHYSICIANS OF LONG BEACH A MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS ENRIQUE MARTINEZ MD (OWNER)
(562) 421-2757
Entity
Organization
Contact information
Practice address
2925 PALO VERDE AVE, LONG BEACH, CA 90815-1552
(562) 421-2757
(562) 420-7267
Mailing address
2925 PALO VERDE AVE, LONG BEACH, CA 90815-1552
(562) 421-2757
(562) 420-7267
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OPT8329TPA
CA
207W00000X
Ophthalmology Physician
Primary
A68745
CA
207W00000X
Ophthalmology Physician
G84806
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710093083
NPI
CA
01
—
1952369399
NPI
CA
05
—
GR0087220
—
CA
Enumeration date
09/05/2006
Last updated
08/24/2021
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