Organization
LYNN EYE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES ALAN COOPER M.D. (OPHTHALMOLOGIST)
(805) 495-0458
Entity
Organization
Contact information
Practice address
2230 LYNN RD STE 102, THOUSAND OAKS, CA 91360-1920
(805) 495-0458
(805) 494-9630
Mailing address
2230 LYNN RD STE 102, THOUSAND OAKS, CA 91360-1920
(805) 495-0458
(805) 494-9630
Taxonomy
Speciality
Code
Description
License number
State
156FX1100X
Ophthalmic Technician/Technologist
Primary
G44847
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G44847
LISCENCE
CA
01
—
WG44847C
PPIN
CA
Enumeration date
03/23/2007
Last updated
08/22/2020
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