Organization
EYECARE SPECIALISTS MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DWAYNE K LOGAN (MEDICAL DIRECTOR)
(562) 938-9945
Entity
Organization
Contact information
Practice address
7677 CENTER AVE STE 102, HUNTINGTON BEACH, CA 92647-3030
(714) 316-0802
(714) 316-0804
Mailing address
14726 RAMONA AVE STE 203, CHINO, CA 91710-5730
(626) 305-9100
(626) 305-0152
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
11/14/2023
Last updated
11/14/2023
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