Organization
SIEMS ADVANCED LASIK AND EYE CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICKIE ELPUSAN (OPHTHALMIC TECHNICIAN)
(949) 718-2010
Entity
Organization
Contact information
Practice address
2121 E COAST HWY, STE 200, CORONA DEL MAR, CA 92625-1931
(949) 718-2010
(949) 718-2011
Mailing address
2121 E COAST HWY, STE 200, CORONA DEL MAR, CA 92625-1931
(949) 718-2010
(949) 718-2011
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
8933T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2018998
—
CA
Enumeration date
04/25/2007
Last updated
08/22/2020
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