# EAST-WEST EYE INSTITUTE A MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** San Pedro Eye Care Medical Group Inc A Professional Medical Corporatio
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447896154
- **Authorized official:** NICOLE TURNER (CREDENTIALING MANAGER)
- **Authorized official phone:** (949) 688-6205

## Contact information

- **Practice address:** 571 W 7TH ST, SAN PEDRO, CA 90731-3115
- **Practice address phone:** (310) 833-1627
- **Practice address fax:** (310) 833-0698
- **Mailing address:** 75 ENTERPRISE STE 200, ALISO VIEJO, CA 92656-2626
- **Mailing address phone:** (949) 688-6205

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |
| 207WX0200X | Ophthalmic Plastic and Reconstructive Surgery Physician | — | NULL | — |
| 207WX0200X | Ophthalmic Plastic and Reconstructive Surgery Physician | — | — | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 11/18/2019
- **Last updated:** 11/09/2023