Med-Laser Surgical Center LLC

Primary specialty

Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X

License

930000999 Issued in CA

Legal business name

MED-LASER SURGICAL CENTER LLC

Practice address

2445 W Whittier Blvd
Suite #100
Montebello, CA 90640-3069

Phone

(323) 727-2550

Fax

(323) 727-2552

NPI assigned

Aug 5, 2006

Organization subpart

No

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

Authorized official

Name

Eric Boon

Title

Officer/Ao

Phone

(480) 567-0269

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Med Laser Surgical CenterCCN 05C0001630

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769990400000",
    "number": "1538178256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2446 W WHITTIER BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906403041",
            "telephone_number": "323-728-5500",
            "fax_number": "323-728-4408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2445 W WHITTIER BLVD",
            "address_2": "SUITE #100",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906403069",
            "telephone_number": "323-727-2550",
            "fax_number": "323-727-2552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED-LASER SURGICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A",
        "authorized_official_last_name": "BOON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OFFICER/AO",
        "authorized_official_telephone_number": "480-567-0269"
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "CA",
            "license": "930000999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nicola Juanita McKellop, FNP
• David McKittrick
• Beth A McVey, NP
• MD Health Network Inc
• MDNP Providers Inc
• Medicare Transportation LLC
• Christopher Medina
• Mehrabian DDS Inc
• Tatevik Mejia
• Yancy Mejia, RADT I

• Ophthalmologic Surgery Clinic/Center in Montebello, CA
• Providers in Montebello, CA by specialty
• Ophthalmologic Surgery Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.