Wellformed AI

NPI 1831536481 · live from the CMS NPI Registry

De La Pena Eye Clinic, A Medical Group, INC

Ophthalmology in Santa Ana, CA. National Provider Identifier 1831536481, active.

NPI record

NPI1831536481 Type 2 · organization
StatusActive
Primary specialtyOphthalmology 207W00000X
Practice location1520 N Grand Ave, Santa Ana, CA 92701
Practice phone714-558-1385
Mailing address401 Commerce St Ste 600, Nashville, TN 37219
EnumeratedMay 22, 2013
Last updatedFebruary 18, 2020
Authorized officialMark Kelly, Member, Board Of Managers
Other namesDe La Pena Eye Clinic, Amg, INC

Taxonomies and licenses

TaxonomyCodeLicense
Optometrist152W00000X—
Ophthalmology primary207W00000X—

Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.