Organization
DOHENY EYE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD E SMITH M.D. (PRESIDENT)
(323) 442-6425
Entity
Organization
Contact information
Practice address
1450 SAN PABLO ST, SUITE 4000, LOS ANGELES, CA 90033-4500
(323) 442-7155
(323) 442-7158
Mailing address
1450 SAN PABLO ST, SUITE 3700, LOS ANGELES, CA 90033-4500
(323) 442-7155
(323) 442-7158
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0059890
—
CA
05
—
GR0059891
—
CA
05
—
GR0059893
—
CA
05
—
GR0059894
—
CA
05
—
GR0059895
—
CA
01
—
ZZZ7157Z
BLUE SHIELD
CA
Enumeration date
07/04/2006
Last updated
02/26/2008
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