# EYECARE SPECIALISTS MEDICAL GROUP, INC

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

## Provider details

- **NPI number:** 1669246104
- **Authorized official:** DWAYNE K LOGAN (MEDICAL DIRECTOR)
- **Authorized official phone:** (562) 938-9945

## Contact information

- **Practice address:** 7677 CENTER AVE STE 102, HUNTINGTON BEACH, CA 92647-3030
- **Practice address phone:** (714) 316-0802
- **Practice address fax:** (714) 316-0804
- **Mailing address:** 14726 RAMONA AVE STE 203, CHINO, CA 91710-5730
- **Mailing address phone:** (626) 305-9100
- **Mailing address fax:** (626) 305-0152

## Taxonomy

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

## Other

- **Enumeration date:** 11/14/2023
- **Last updated:** 11/14/2023