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MED-LASER SURGICAL CENTER LLC NPI 1538178256


NPI Information

NPI: 1538178256
Provider Name: MED-LASER SURGICAL CENTER LLC
Classification: Clinic/Center - 261QS0132X
Entity Type: Organization

Specialization: Ophthalmologic Surgery

CLIA Number: 05D1010969

Address:
2445 W WHITTIER BLVD
SUITE #100
MONTEBELLO, CA
ZIP 90640
Phone: (323) 727-2550
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MED-LASER SURGICAL CENTER LLC is an ophthalmologic surgery clinic center in Montebello, CA. MED-LASER SURGICAL CENTER LLC NPI is 1538178256. The provider is registered as an organization entity type.

The provider's business location address is:

2445 W WHITTIER BLVD
SUITE #100
MONTEBELLO, CA
ZIP 90640-069
Phone: (323) 727-2550
Fax: (323) 727-2552

The provider's authorized official is William C De La Pena .
The authorized official title is President/ Medical Director and has the following contact phone number (323) 728-5500.

The CLIA number assigned to this NPI record is 05D1010969 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/5/2006 and was last updated on 6/6/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QS0132XClinic/CenterOphthalmologic Surgery930000999CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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