Retinal Consultants Of Southern California Medical Group, Inc
LBN: Retinal Consultants Of Southern California Medical Group, Inc
Retinal Consultants Of Southern California Medical Group, Inc is an health care organization with primary practice located at 1220 La Venta Dr Suite 211, Westlake Village CA 91361-3703. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty.
Retinal Consultants Of Southern California Medical Group, Inc can be contacted via phone (805) 379-0200, or through Diddie, Kenneth Robert via phone (805) 379-0200.
Contact Information
Primary practice address
1220 La Venta Dr Suite 211
Westlake Village CA 91361-3703
Phone: (805) 379-0200
Fax: (805) 496-5204
Website:
Authorized official contact:
Name: Diddie, Kenneth Robert Doctor of Medicine (MD)
Phone: (805) 379-0200
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | G33939 | California |
Profile Details
| NPI number | 1700807815 |
|---|---|
| LBN Legal business name | Retinal Consultants Of Southern California Medical Group, Inc |
| DBA Doing business as | |
| Authorized official | Diddie, Kenneth Robert Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 22nd, 2006 |
| Last updated | Sep 26th, 2023 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700807815 | NPPES |
| California | Other | CP5288 | RAILROAD MEDICARE |
| California | MEDICAID | 00G339391 | RAILROAD MEDICARE |
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