1831494426 NPI number — CALIFORNIA EYE PROFESSIONALS MEDICAL GROUP INC PC

Table of content: WARREN HARDY SCOTT M.D. (NPI 1023073350)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831494426 NPI number — CALIFORNIA EYE PROFESSIONALS MEDICAL GROUP INC PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CALIFORNIA EYE PROFESSIONALS MEDICAL GROUP INC PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831494426
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/13/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
29826 HAUN RD
Provider Second Line Business Mailing Address:
STE 100
Provider Business Mailing Address City Name:
MENIFEE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92586-6546
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
951-301-8888
Provider Business Mailing Address Fax Number:
951-301-4137

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
29826 HAUN RD
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
MENIFEE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92586-6546
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-301-8888
Provider Business Practice Location Address Fax Number:
951-301-4137
Provider Enumeration Date:
01/13/2011

Additional Information

Authorized Official

Authorized Official Last Name:
BLASE
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
951-301-8888

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  G50680 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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