Organization
KINGS EYE CENTER MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA J LEE-THOMAS (ADMINISTRATOR)
(559) 585-3937
Entity
Organization
Contact information
Practice address
1395 W LACEY BLVD, HANFORD, CA 93230-5904
(559) 585-3937
(559) 582-3645
Mailing address
1395 W LACEY BLVD, HANFORD, CA 93230-5904
(559) 585-3937
(559) 582-3645
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
490005146
RR MEDICARE
CA
05
—
GR0091100
—
CA
05
—
GSD004060
—
CA
Enumeration date
01/16/2006
Last updated
06/06/2013
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