# MARY KAY MICHELIS MD INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** HULL EYE SURGERY CENTER
- **Other names:** HULL EYE CENTER
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1235308164
- **Legal business name:** HULL EYE SURGERY CENTER
- **Authorized official:** REGINALD SAMPSON MD (OFFICER)
- **Authorized official phone:** (661) 945-4502

## Contact information

- **Practice address:** 1739 W AVENUE J, LANCASTER, CA 93534-2703
- **Practice address phone:** (661) 945-4502
- **Practice address fax:** (661) 945-4841
- **Mailing address:** 1739 W AVENUE J, LANCASTER, CA 93534-2703
- **Mailing address phone:** (661) 945-4502
- **Mailing address fax:** (661) 945-4841

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/25/2008
- **Last updated:** 02/25/2008