San Diego Eye Bank

Primary specialty

Eye BankTaxonomy code 332G00000X

License

CNC80040 Issued in CA

Legal business name

SAN DIEGO EYE BANK

Practice address

9444 Balboa Ave
Suite 100
San Diego, CA 92123-4447

Phone

(858) 694-0444

Fax

(858) 565-7368

NPI assigned

Feb 28, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Jeffrey G Penta

Title

Executive Director

Phone

(858) 694-0444

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326176702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9444 BALBOA AVE",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234447",
            "telephone_number": "858-694-0444",
            "fax_number": "858-565-7368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9444 BALBOA AVE",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234447",
            "telephone_number": "858-694-0444",
            "fax_number": "858-565-7368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO EYE BANK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PENTA",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "858-694-0444",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332G00000X",
            "taxonomy_group": "",
            "desc": "Eye Bank",
            "state": "CA",
            "license": "CNC80040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Eye Bank in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.