Organization
DE LA PENA EYE CLINIC, A MEDICAL GROUP, INC
Active
Other names
De La Pena Eye Clinic, AMG, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MARK KELLY (MEMBER, BOARD OF MANAGERS)
(615) 345-6900
Entity
Organization
Contact information
Practice address
7100 VAN NUYS BLVD, SUITE 120, VAN NUYS, CA 91405-3063
(818) 988-1111
(818) 988-1261
Mailing address
401 COMMERCE ST STE 600, NASHVILLE, TN 37219-2518
(615) 345-6900
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
05/22/2013
Last updated
02/18/2020
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