Organization
CENTER FOR RETINAL AND MACULAR DISEASES, INC.
Active
Other names
Center for Retinal and Macular Diseases
Organization subpart
No
Provider details
NPI number
Authorized official
LEONID E. LERNER M.D., PH.D. (MEDICAL DIRECTOR)
(949) 500-3207
Entity
Organization
Contact information
Practice address
1440 AVOCADO AVENUE, SUITE 204, NEWPORT BEACH, CA 92660
(949) 721-1701
(949) 612-1910
Mailing address
1441 AVOCADO AVE, SUITE 204, NEWPORT BEACH, CA 92660-7721
(949) 500-3207
(949) 612-1910
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A54458
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CT593A
MEDICARE PTAN
CA
01
—
CT593B
MEDICARE PTAN
CA
Enumeration date
07/04/2009
Last updated
05/01/2015
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