Organization
MIRAMAR EYE SPECIALISTS MEDICAL GROUP, INC
Active
Other names
MIRAMAR EYE SPECIALISTS MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOEL CORWIN (PRESIDENT/MEDICAL DIRECTOR)
(805) 583-3950
Entity
Organization
Contact information
Practice address
3085 LOMA VISTA RD, VENTURA, CA 93003-2916
(805) 648-3085
(805) 648-7027
Mailing address
3085 LOMA VISTA RD, VENTURA, CA 93003-2916
(805) 648-3085
(805) 648-7027
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110369658
CHAMPUS
CA
01
—
205153800
US DEPT. OF LABOR
CA
01
—
CI5426
RAILROAD MEDICARE
CA
05
—
GR0076890
—
CA
01
—
ZZZ51212Z
BLUE SHIELD
CA
Enumeration date
06/09/2006
Last updated
02/11/2025
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