Organization
DE LA PENA EYE CLINIC, A MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK KELLY (BOARD MEMBER)
(615) 345-6900
Entity
Organization
Contact information
Practice address
10942 RAMONA BLVD STE A, EL MONTE, CA 91731-2644
(323) 728-5500
Mailing address
401 COMMERCE ST STE 600, NASHVILLE, TN 37219-2518
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
03/25/2020
Last updated
03/25/2020
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