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NPI 1952748501 · live from the CMS NPI Registry

De La Pena Eye Clinic, A Medical Group, INC

Ophthalmology in Van Nuys, CA. National Provider Identifier 1952748501, active.

NPI record

NPI1952748501 Type 2 · organization
StatusActive
Primary specialtyOphthalmology 207W00000X
Practice location7100 Van Nuys Blvd, Suite 120, Van Nuys, CA 91405
Practice phone818-988-1111
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.