Provider Demographics
NPI:1861783599
Name:EYELID INSTITUTE INC
Entity type:Organization
Organization Name:EYELID INSTITUTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:HUI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-610-2677
Mailing Address - Street 1:41990 COOK ST
Mailing Address - Street 2:SUITE F1007
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-6100
Mailing Address - Country:US
Mailing Address - Phone:760-610-2677
Mailing Address - Fax:760-610-6101
Practice Address - Street 1:41990 COOK ST
Practice Address - Street 2:SUITE F1007
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-6100
Practice Address - Country:US
Practice Address - Phone:760-610-2677
Practice Address - Fax:760-610-6101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-28
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA115818207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2759357-00Medicaid
FLI73406Medicare UPIN
CAFI593AMedicare UPIN