# SOUTH LA EYE CLINIC

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

## Provider details

- **NPI number:** 1710706874
- **Authorized official:** MR. LUIS MALDONADO (OFFICE MANAGER)
- **Authorized official phone:** (760) 996-3507

## Contact information

- **Practice address:** 231 W VERNON AVE STE 104, LOS ANGELES, CA 90037-2778
- **Practice address phone:** (323) 233-6271
- **Practice address fax:** (323) 233-8196
- **Mailing address:** 646 W MAIN ST, EL CENTRO, CA 92243-7914
- **Mailing address phone:** (760) 996-3507
- **Mailing address fax:** (442) 271-4337

## Taxonomy

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

## Other

- **Enumeration date:** 10/07/2024
- **Last updated:** 10/07/2024