Organization
DE LA PENA EYE CLINIC, A MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK KELLY (MEMBER, BOARD OF MANAGERS)
(615) 345-6900
Entity
Organization
Contact information
Practice address
2446 W WHITTIER BLVD, MONTEBELLO, CA 90640-3041
(323) 728-5500
(323) 728-4408
Mailing address
401 COMMERCE ST STE 600, NASHVILLE, TN 37219-2518
(615) 345-6900
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
07/28/2006
Last updated
08/12/2022
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