Organization
LOS ANGELES INSTITUTE FOR OPHTHALMIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID MICHAEL COLVARD M.D. (PRESIDENT)
(818) 906-2929
Entity
Organization
Contact information
Practice address
5363 BALBOA BLVD, SUITE 545, ENCINO, CA 91316-2805
(818) 906-2929
(818) 906-0567
Mailing address
5363 BALBOA BLVD, SUITE 545, ENCINO, CA 91316-2805
(818) 906-2929
(818) 906-0567
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G39377
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0071330
—
CA
Enumeration date
09/20/2006
Last updated
01/27/2010
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