EYECARE SPECIALISTS MEDICAL GROUP, INC.


Address: 23521 Paseo De Valencia, Suite 305, Laguna Hills, CA 92653-3107
Phone: 9495811770

EYECARE SPECIALISTS MEDICAL GROUP, INC. (NPI# 1487762159) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1487762159
Entity Type Organization
Organization Name EYECARE SPECIALISTS MEDICAL GROUP, INC.
Other Organization Name ATLANTIS EYECARE
Practice Address 23521 Paseo De Valencia
Suite 305
Laguna Hills
CA 92653-3107
Mailing Address 888 S Disneyland Dr
Suite 100
Anaheim
CA 92802-1847
Practice Telephone 9495811770
Practice Fax Number 9494542002
Mailing Telephone 7143990678
Mailing Fax Number 7142766489
Enumeration Date 2006-08-25
Last Update Date 2013-08-23
Authorized Official Name DWAYNE KEITH LOGAN (CEO)
Authorized Official Telephone 7143990678
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 152W00000X Optometrist Eye and Vision Services Providers
Y 207W00000X Ophthalmology Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
CA BLUE SHIELD ZZZ65057Z 01

Other Provider/Organization Names

Other Name Type Code
Atlantis Eyecare Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1114547619 Eyecare Specialists Medical Group, Inc. Optometrist 1711 W Temple St Ste 5665, Los Angeles, CA 90026-5421 2020-04-24
1538791025 Eyecare Specialists Medical Group, Inc. Optometrist 1595 E 17th St, Santa Ana, CA 92705-8506 2020-02-12
1942392238 Eyecare Specialists Medical Group, Inc. Optometrist 475 W. Badillo St., Covina, CA 91723-1902 2006-09-28
1619597119 Eyecare Specialists Medical Group, Inc. Optometrist 231 W Vernon Ave Ste 104, Los Angeles, CA 90037-2778 2020-04-24
1922529700 Eyecare Specialists Medical Group, Inc. Ophthalmology 490 Post St Ste 933, San Francisco, CA 94102-1414 2017-06-30
1154878478 Eyecare Specialists Medical Group, Inc. Ophthalmology 7677 Center Ave, Suite 102, Huntington Beach, CA 92647-3074 2016-09-02
1790173508 Eyecare Specialists Medical Group, Inc. Optometrist 22525 Maple Ave, Suite 100, Torrance, CA 90505-2700 2014-12-31
1255649612 Eyecare Specialists Medical Group, Inc. Ophthalmology 1360 W 6th St, North Bldg Suite 125, San Pedro, CA 90732-3514 2010-09-20
1750488169 Eyecare Specialists Medical Group, Inc. Optometrist 7677 Center Ave, Suite 301, Huntington Beach, CA 92647-3074 2006-09-20
1568494649 Eyecare Specialists Medical Group, Inc. Optometrist 8311 Florence Ave, Downey, CA 90240-3928 2006-07-07

Office Location

Street Address 23521 PASEO DE VALENCIA
SUITE 305
City LAGUNA HILLS
State CA
Zip Code 92653-3107

Providers in the same location

NPI Name Taxonomy Address Enumeration
1376540575 Christine Evelyn Fritz Physician Assistant 23521 Paseo De Valencia, Suite #204, Laguna Hills, CA 92653-3107 2005-07-01
1073137238 Allison Helen Paris Physical Therapist 23521 Paseo De Valencia, Suite B7, Laguna Hills, CA 92653-3107 2020-06-03
1568823714 Sarah S. Teymoorian, Md, Inc. Internal Medicine 23521 Paseo De Valencia, Suite 108, Laguna Hills, CA 92653-3137 2016-03-16
1841675816 John C Hwang Md Mba Inc Ophthalmology 23521 Paseo De Valencia, Suite 207, Laguna Hills, CA 92653-3107 2015-07-20
1376949826 William Parks Dentist 23521 Paseo De Valencia, #112, Laguna Hills, CA 92653-3107 2014-11-11
1881019818 Positive Healthy Aging, Inc. Family Medicine 23521 Paseo De Valencia, Suite 311, Laguna Hills, CA 92653-3107 2014-02-27
1912328865 Chi-whei Lin, Md, Inc. Internal Medicine 23521 Paseo De Valencia, Suite 310, Laguna Hills, CA 92653-3107 2013-12-19
1194161703 Jorge A. Rivero, M.d., Inc. Family Medicine 23521 Paseo De Valencia, Suite 108, Laguna Hills, CA 92653-3107 2013-05-22
1336491901 Beautymark Anti Aging & Welness Center Internal Medicine 23521 Paseo De Valencia, Suite 310, Laguna Hills, CA 92653-3107 2012-10-08
1376800375 Sarah Kay Selag Herrera Pediatrics 23521 Paseo De Valencia, Suite 200, Laguna Hills, CA 92653-3107 2012-04-13
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1932708476 Nikkie Veyseh Behavior Technician 26921 Falling Leaf Dr., Laguna Hills, CA 92653 2020-10-24
1609480425 Steve Ceja Behavior Technician 25201 Paseo De Alicia Suite 110, Laguna Hills, CA 92653 2020-08-31
1467006882 Kristina Alexa Puno Morales Dietitian, Registered 24552 Health Center Drive, Laguna Hills, CA 92653 2019-07-25
1164929626 Shoreline Consulting Services, Inc. Clinic/Center 23010 Lake Forest Drive, Suite B, Laguna Hills, CA 92653 2018-04-11
1023511045 Performance Health Medical Group Non-Pharmacy Dispensing Site 25431 Cabot Road Suite 118, Laguna Hills, CA 92653 2018-03-15
1831613850 Stephani A Berg Physical Medicine & Rehabilitation 24422 Avenida De La Carlota Suite 190, Laguna Hills, CA 92653 2017-08-01
1497299945 Stephanie Lyle Nurse Practitioner 24221 Calle De Louisa, Suite 400, Laguna Hills, CA 92653 2016-12-16
1053776278 Meillanny Gladness Counselor 23151 Verdugo Dr Ste 203, Laguna Hills, CA 92653 2015-12-16
1912383183 Pmdca, LLC Clinical Medical Laboratory 23297 S Pointe Dr Ste 100, Laguna Hills, CA 92653 2015-08-10
1821486630 4mpw, Inc. Home Health 23232 Peralta Drive 216, Laguan Hills, CA 92653 2014-12-31
Find all providers in zip 92653

Taxonomy Information

Taxonomy Code 207W00000X
Grouping Allopathic & Osteopathic Physicians
Classification Ophthalmology

Taxonomy Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1093011942 George M. Salib, M.d. Inc. Ophthalmology 24422 Avenida De La Carlota Ste 110, Laguna Hills, CA 92653-3634 2011-02-09
1841675816 John C Hwang Md Mba Inc Ophthalmology 23521 Paseo De Valencia, Suite 207, Laguna Hills, CA 92653-3107 2015-07-20
1609213933 Charles C Manger IIi Ophthalmology 23161 Moulton Pkwy, Laguna Hills, CA 92653-1206 2013-05-28
1508130741 Lecc General Ophthalmology Management Ophthalmology 24022 Calle De La Plata, Suite 300, Laguna Hills, CA 92653-3629 2012-03-06
1558651729 Jonathan R Pirnazar M.d. A PC Ophthalmology 24022 Calle De La Plata, Suite 300, Laguna Hills, CA 92653-3626 2011-04-08
1437389822 Duna A Raoof Ophthalmology 24401 Calle De La Louisa, 300, Laguna Hills, CA 92653-3623 2009-07-20
1477713030 Brian Takemoto Kim Ophthalmology 24401 Calle De La Louisa, Suite 300, Laguna Hills, CA 92653-3623 2008-06-16
1306026281 Savak Teymoorian Ophthalmology 24401 Calle De La Louisa, Suite 300, Laguna Hills, CA 92653-3623 2007-11-08
1710174578 Jude J Santiago M D Inc Ophthalmology 24953 Paseo De Valencia, Suite 6a, Laguna Hills, CA 92653-4342 2007-09-26
1679764732 William L Mc Carthy Jr Md Inc Ophthalmology 24411 Health Center Dr, Suite 340, Laguna Hills, CA 92653-3651 2007-08-05
Find all providers in LAGUNA HILLS

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City LAGUNA HILLS
Zip Code 92653

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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