# 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:** 1619597119
- **Authorized official:** FELISA MARISOL GALINDO (CREDENTIALING SUPERVISOR)
- **Authorized official phone:** (626) 305-9100

## Contact information

- **Practice address:** 231 W VERNON AVE STE 104, LOS ANGELES, CA 90037-2778
- **Practice address phone:** (310) 819-9500
- **Practice address fax:** (323) 703-1301
- **Mailing address:** 1595 E 17TH ST, SANTA ANA, CA 92705-8506
- **Mailing address phone:** (714) 399-0678
- **Mailing address fax:** (714) 276-6489

## Taxonomy

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

## Other

- **Enumeration date:** 04/24/2020
- **Last updated:** 11/28/2022