Organization
ST. MARY'S EYE CENTER
Active
Organization
ST. MARY'S EYE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH J. HOFFER M.D. (OWNER)
(310) 451-2020
Entity
Organization
Contact information
Practice address
2222 SANTA MONICA BLVD, SUITE 107, SANTA MONICA, CA 90404-2304
(310) 451-2020
(310) 451-1316
Mailing address
1605 SAN VICENTE BLVD, SANTA MONICA, CA 90402-2207
(310) 451-2020
(310) 451-1316
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
H512723
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G17108
MEDICAL LICENSE
CA
Enumeration date
03/06/2009
Last updated
03/06/2009
Update your record
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