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Organization

AZUL VISION INC.

Active
Other names
AZUL VISION
Organization subpart
No

Provider details

NPI number
Authorized official
DWAYNE KEITH LOGAN MD (MD/CEO)
(714) 399-0678
Entity
Organization

Contact information

Practice address
2619 E COLORADO BLVD # 150, PASADENA, CA 91107-3747
(626) 793-4168
Mailing address
14726 RAMONA AVE STE 203, CHINO, CA 91710-5730
(626) 305-9100
(626) 305-0152

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
207W00000X
Ophthalmology Physician
Primary
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
207WX0107X
Retina Specialist (Ophthalmology) Physician
207WX0110X
Pediatric Ophthalmology and Strabismus Specialist Physician
207WX0120X
Cornea and External Diseases Specialist Physician
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner

Other

Enumeration date
08/26/2020
Last updated
04/30/2026
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