Kevin J Prendiville, MD | |
11 Cobalt Dr, Dana Point, CA 92629-5906 | |
(949) 388-9718 | |
(949) 388-9215 |
Full Name | Kevin J Prendiville |
---|---|
Gender | Male |
Speciality | Ophthalmology |
Location | 11 Cobalt Dr, Dana Point, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1588636765 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207W00000X | Ophthalmology | G45074 (California) | Primary |
Entity Name | Shaaf Eye Center Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1801954417 PECOS PAC ID: 3476522020 Enrollment ID: O20040929001274 |
Entity Name | Pacific Eye Institute A Medical Group Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1962422709 PECOS PAC ID: 7911966122 Enrollment ID: O20041004001187 |
Entity Name | South Coast Eye Care Centers |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1063459725 PECOS PAC ID: 0547299901 Enrollment ID: O20050806000096 |
Entity Name | Emergency Associates Corporation |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1003866120 PECOS PAC ID: 8022196518 Enrollment ID: O20080424000144 |
Entity Name | Prendiville Properties, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1972911097 PECOS PAC ID: 1456579325 Enrollment ID: O20140908000226 |
Mailing Address | Practice Location Address |
---|---|
Kevin J Prendiville, MD 11 Cobalt Dr, Dana Point, CA 92629-5906 Ph: (949) 388-9718 | Kevin J Prendiville, MD 11 Cobalt Dr, Dana Point, CA 92629-5906 Ph: (949) 388-9718 |