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
5991 E. SPRING ST., LONG BEACH, CA 90808
(562) 938-9945
(562) 496-0433
Mailing address
888 S DISNEYLAND DR, SUITE 100, ANAHEIM, CA 92802-1847
(714) 604-4621
(714) 829-3232
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
W14969
CA
207W00000X
Ophthalmology Physician
Primary
W14969
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ01505Z
BLUE SHIELD
CA
Enumeration date
09/11/2006
Last updated
11/28/2022
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