Organization
EYECARE SPECIALISTS MEDICAL GROUP, INC.
Active
Other names
Atlantis Eyecare
Organization subpart
No
Provider details
NPI number
Authorized official
FELISA MARISOL GALINDO (CREDENTIALING SUPERVISOR)
(626) 305-9100
Entity
Organization
Contact information
Practice address
23521 PASEO DE VALENCIA, SUITE 305, LAGUNA HILLS, CA 92653-3107
(949) 581-1770
(949) 454-2002
Mailing address
888 S DISNEYLAND DR, SUITE 100, ANAHEIM, CA 92802-1847
(714) 399-0678
(714) 276-6489
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ65057Z
BLUE SHIELD
CA
Enumeration date
08/25/2006
Last updated
11/28/2022
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