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Organization
CALIFORNIA EYE PROFESSIONALS MEDICAL GROUP INC
Active
Organization
CALIFORNIA EYE PROFESSIONALS MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM BLASE MD (OWNER)
(951) 652-6100
Entity
Organization
Contact information
Practice address
41637 MARGARITA RD, SUITE 100, TEMECULA, CA 92591-2990
(951) 296-9300
Mailing address
41637 MARGARITA RD, SUITE 100, TEMECULA, CA 92591-2990
(951) 296-9300
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0069960
—
CA
Enumeration date
07/31/2006
Last updated
01/29/2010
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