# EYE CARE ASSOCIATES OF SAN DIEGO MEDICAL GROUP, INC.

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

## Provider details

- **NPI number:** 1467714311
- **Authorized official:** MR. ANDY LOCK (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (858) 274-6828

## Contact information

- **Practice address:** 4455 MORENA BLVD, SUITE 203, SAN DIEGO, CA 92117-4358
- **Practice address phone:** (858) 274-6828
- **Practice address fax:** (858) 274-6861
- **Mailing address:** 4455 MORENA BLVD., SUITE 203, SAN DIEGO, CA 92117-4358
- **Mailing address phone:** (858) 274-6828
- **Mailing address fax:** (858) 274-6861

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/15/2012
- **Last updated:** 06/15/2012