Organization
EAST-WEST EYE INSTITUTE A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICOLE TURNER (CREDENTIALING MANAGER)
(949) 688-6205
Entity
Organization
Contact information
Practice address
879 W 190TH ST STE 100, GARDENA, CA 90248-4223
(310) 329-9975
(310) 329-4759
Mailing address
75 ENTERPRISE STE 200, ALISO VIEJO, CA 92656-2626
(949) 688-6205
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
—
—
207WX0107X
Retina Specialist (Ophthalmology) Physician
—
—
207WX0120X
Cornea and External Diseases Specialist Physician
—
—
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0078581
—
CA
Enumeration date
01/11/2008
Last updated
11/09/2023
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