NPIMap

Organization Active NPI

East-West Eye Institute a Medical Corporation

  • Ophthalmology Physician
  • San Pedro, CA
National Provider Identifier
1447896154
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
EAST-WEST EYE INSTITUTE A MEDICAL CORPORATION
Practice address
571 W 7TH St
San Pedro, CA 90731-3115
Phone
(310) 833-1627
Fax
(310) 833-0698
NPI assigned
Nov 18, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Authorized official

Name
Nicole Turner
Title
Credentialing Manager
Phone
(949) 688-6205

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary
Ophthalmic Plastic and Reconstructive Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207WX0200X
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

571 W 7TH St
San Pedro, CA 90731-3115

Mailing address

75 Enterprise Ste 200
Aliso Viejo, CA 92656-2626
Phone (949) 688-6205

Other names 1

  • San Pedro Eye Care Medical Group Inc A Professional Medical Corporatio Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040702001125 CA Part B Supplier - Clinic/Group Practice 0042297376 Receives reassigned benefits from 25 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Pedro, CA; Torrance, CA; Gardena, CA; Covina, CA
O20200417002722 CA DME Supplier - Physician - OphthalmologyDME Supplier - Physician - Optometrist 0042297376 Practice locations: San Pedro, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
Tax ID family
East-West Eye Institute3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

420 E 3rd St
Ste 603
Los Angeles, CA 90013
Phone (213) 625-2694

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699488000000",
    "number": "1447896154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 ENTERPRISE STE 200",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926562626",
            "telephone_number": "949-688-6205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 W 7TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313115",
            "telephone_number": "310-833-1627",
            "fax_number": "310-833-0698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST-WEST EYE INSTITUTE A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-18",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "949-688-6205"
    },
    "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
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Pedro Eye Care Medical Group Inc A Professional Medical Corporatio",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "San Pedro Eye Care Medical Group Inc A Professional Medical Corporatio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Pedro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.