Provider Demographics
NPI:1548937402
Name:VISION PROTECTION INSTITUTE OF BEVERLY HILLS INC
Entity type:Organization
Organization Name:VISION PROTECTION INSTITUTE OF BEVERLY HILLS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:K
Authorized Official - Last Name:LUTTRULL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:424-303-7394
Mailing Address - Street 1:9777 WILSHIRE BLVD STE 910
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-1902
Mailing Address - Country:US
Mailing Address - Phone:424-303-7394
Mailing Address - Fax:424-303-7397
Practice Address - Street 1:9777 WILSHIRE BLVD STE 910
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-1902
Practice Address - Country:US
Practice Address - Phone:424-303-7394
Practice Address - Fax:424-303-7397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-26
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Multi-Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty