Retinal Consultants Of Southern California Medical Group, Inc in Westlake Village - Specialist
Retinal Consultants Of Southern California Medical Group, Inc - NPI 1700807815
Retinal Consultants Of Southern California Medical Group, Inc is a Specialist in Westlake Village, California. Retinal Consultants Of Southern California Medical Group, Inc practices all healthcare services and medical treatments related to Specialist. The NPI Number for Retinal Consultants Of Southern California Medical Group, Inc is 1700807815. The last update date is 2023-09-26.
Retinal Consultants Of Southern California Medical Group, Inc's current location address is 1220 La Venta Dr, Westlake Village, California. You can contact this provider via phone number 8053790200 and fax number 8054965204. The mailing address for Retinal Consultants Of Southern California Medical Group, Inc is 1220 La Venta Dr, Westlake Village, California. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Retinal Consultants Of Southern California Medical Group, Inc |
|---|---|
| Address | 1220 La Venta Dr, Westlake Village, California |
| Phone Number | 8053790200 |
| Fax Number | 8054965204 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Diddie Robert Kenneth |
| Credentials | MD |
| Telephone Number | 8053790200 |
NPI Number Detail
| NPI Number | 1700807815 |
|---|---|
| Provider Enumeration Date | 2006-07-22 |
| Last Updated Date | 2023-09-26 |
Provider Mailing Address Detail
| Address | 1220 La Venta Dr |
|---|---|
| City | Westlake Village |
| State | California (CA) |
| Post Code | 913613703 |
| Phone Number | 8053790200 |
| Fax Number | 8054965204 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | G33939 |
|
Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| CP5288 | CA | RAILROAD MEDICARE | |
| 00G339391 | CA | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Retinal Consultants Of Southern California Medical Group, Inc by the Centers for Medicare & Medicaid Services?
The Retinal Consultants Of Southern California Medical Group, Inc has been issued the NPI (National Provider Identifier) 1700807815, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Retinal Consultants Of Southern California Medical Group, Inc is located?
The Retinal Consultants Of Southern California Medical Group, Inc is situated at the following address: 1220 La Venta Dr, Westlake Village, CA, 913613703.
What is Retinal Consultants Of Southern California Medical Group, Inc's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Retinal Consultants Of Southern California Medical Group, Inc is Specialist, and the taxonomy code that categorizes this field of expertise is 174400000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1700807815 to Retinal Consultants Of Southern California Medical Group, Inc?
The Centers for Medicare & Medicaid Services assigned the 1700807815 to Retinal Consultants Of Southern California Medical Group, Inc on 2006-07-22.
As of what date were the details related to Retinal Consultants Of Southern California Medical Group, Inc most recently updated or revised?
The information pertaining to Retinal Consultants Of Southern California Medical Group, Inc, including its address, specialty, and other relevant details, was last updated or revised on 2023-09-26.
NPI Number: 1487640876
Address: 587 5th St W, Sonoma, CA