# EYECARE SPECIALISTS 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
- **Other names:** Atlantis Eyecare
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528162690
- **Authorized official:** FELISA MARISOL GALINDO (CREDENTIALING SUPERVISOR)
- **Authorized official phone:** (626) 305-9100

## Contact information

- **Practice address:** 5991 E. SPRING ST., LONG BEACH, CA 90808
- **Practice address phone:** (562) 938-9945
- **Practice address fax:** (562) 496-0433
- **Mailing address:** 888 S DISNEYLAND DR, SUITE 100, ANAHEIM, CA 92802-1847
- **Mailing address phone:** (714) 604-4621
- **Mailing address fax:** (714) 829-3232

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | W14969 | CA | — |
| 207W00000X | Ophthalmology Physician | W14969 | CA | Yes |

## Other

- **Enumeration date:** 09/11/2006
- **Last updated:** 11/28/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | ZZZ01505Z | BLUE SHIELD | CA |