Individual
DR. DWAYNE KEITH LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5991 E SPRING ST, LONG BEACH, CA 90808-3752
(562) 938-9945
(562) 496-0433
Mailing address
14726 RAMONA AVE STE 203, CHINO, CA 91710-5730
(626) 305-9100
(626) 305-0152
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G68583
CA
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
G68583
CA
207WX0120X
Cornea and External Diseases Specialist Physician
G68583
CA
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
G68583
CA
Other
Enumeration date
09/20/2006
Last updated
06/13/2024
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