Organization
VISIONARY EYE INSTITUTE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ASHLEY LOPEZ (OFFICE ADMINISTRATOR)
(909) 320-0809
Entity
Organization
Contact information
Practice address
361 HOSPITAL RD STE 324, NEWPORT BEACH, CA 92663-3524
(949) 528-3608
(949) 528-3910
Mailing address
361 HOSPITAL RD STE 324, NEWPORT BEACH, CA 92663-3524
(949) 528-3608
(949) 528-3910
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
—
—
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114025780
—
CA
Enumeration date
10/15/2019
Last updated
10/12/2020
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