NPIMap

Organization Active NPI

California Center for Refractive Surgery

  • Specialist
  • Los Angeles, CA
National Provider Identifier
1356761506
Registry record updated Apr 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G77461 Issued in CA
Legal business name
CALIFORNIA CENTER FOR REFRACTIVE SURGERY
Practice address
4160 Wilshire Blvd
2ND Floor
Los Angeles, CA 90010-3567
Phone
(323) 933-3111
Fax
(323) 933-3393
NPI assigned
Apr 25, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2014

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

Authorized official

Name
Paul C Lee
Title
President/Ceo
Phone
(323) 933-3111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X G77461 CA Primary

Addresses

Primary practice location

4160 Wilshire Blvd
2ND Floor
Los Angeles, CA 90010-3567

Mailing address

4160 Wilshire Blvd
2ND Floor
Los Angeles, CA 90010-3567
Phone (323) 933-3111

Other identifiers 1

IdentifierTypeStateIssuer
W15209MedicaidCA

National Provider Directory

National Provider Directory

Locations

4160 Wilshire Blvd
#2
Los Angeles, CA 90010
Phone (323) 933-3111

NPI Registry JSON

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

{
    "created_epoch": "1398384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398384000000",
    "number": "1356761506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 WILSHIRE BLVD",
            "address_2": "2ND FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103567",
            "telephone_number": "323-933-3111",
            "fax_number": "323-933-3393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 WILSHIRE BLVD",
            "address_2": "2ND FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103567",
            "telephone_number": "323-933-3111",
            "fax_number": "323-933-3393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA CENTER FOR REFRACTIVE SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-25",
        "last_updated": "2014-04-25",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "323-933-3111"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G77461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "W15209",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2014; 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.