NPI 1114931052 · live from the CMS NPI Registry
De La Pena Eye Clinic, A Medical Group, INC.
Ophthalmology in Montebello, CA. National Provider Identifier 1114931052, active.
NPI record
| NPI | 1114931052 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Ophthalmology 207W00000X |
| Practice location | 2446 W Whittier Blvd, Montebello, CA 90640 |
| Practice phone | 323-728-5500 |
| Mailing address | 401 Commerce St Ste 600, Nashville, TN 37219 |
| Enumerated | July 28, 2006 |
| Last updated | August 12, 2022 |
| Authorized official | Mark Kelly, Member, Board Of Managers |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist | 152W00000X | — |
| Ophthalmology primary | 207W00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.