NPIMap

Organization Active NPI

De la Pena Eye Clinic, a Medical Group, Inc.

Doing business as DLP Eye Group

  • Ophthalmology Physician
  • Long Beach, CA
National Provider Identifier
1285412007
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
DE LA PENA EYE CLINIC, A MEDICAL GROUP, INC.
Doing business as
DLP Eye Group
Practice address
1760 Termino Ave Ste 306
Long Beach, CA 90804-2182
Phone
(323) 728-5500
NPI assigned
Sep 21, 2023
Last updated
Sep 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
George Ard
Title
President, Board of Managers
Phone
(615) 717-7135

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1760 Termino Ave Ste 306
Long Beach, CA 90804-2182

Mailing address

Attn Licensing, 401 Commerce Street
Suite 600
Nashville, TN 37219-2518
Phone (615) 760-6593

Other names 1

  • DLP Eye Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031223000882 CA Part B Supplier - Clinic/Group Practice 2961300116 Receives reassigned benefits from 36 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Huntington Park, CA; Whittier, CA; Van Nuys, CA; Santa Ana, CA; Montebello, CA; Los Angeles, CA; Long Beach, CA; El Monte, CA

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 35

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1695254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695254400000",
    "number": "1285412007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ATTN LICENSING, 401 COMMERCE STREET",
            "address_2": "SUITE 600",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372192518",
            "telephone_number": "615-760-6593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 TERMINO AVE STE 306",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908042182",
            "telephone_number": "323-728-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DE LA PENA EYE CLINIC, A MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-21",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "ARD",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT, BOARD OF MANAGERS",
        "authorized_official_telephone_number": "615-717-7135"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DLP Eye Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.