| Organization Name: | LOBUE LASER AND EYE MEDICAL CENTER, INC |
| NPI Number: | 1053743195 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THOMAS DAVID LOBUE (PRESIDENT) |
| Mailing Address: | 40945 Winchester Rd Temecula |
| State: | CA US |
| Postal Code: | 925916031 |
| Phone Number: | 9516961135 |
| Fax Number: | 9516988621 |
| NPI Enumeration Date: | 07/31/2013 |
| NPI Last Update Date: | 07/31/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1100X |
| License Number: | G598470 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Ophthalmic |
| Taxonomy Definition: | |