Provider Demographics
NPI:1366156549
Name:EYECONIC EYE GROUP
Entity type:Organization
Organization Name:EYECONIC EYE GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:REZA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-980-8906
Mailing Address - Street 1:20072 SW BIRCH ST STE 210
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-0799
Mailing Address - Country:US
Mailing Address - Phone:949-270-6063
Mailing Address - Fax:949-270-6064
Practice Address - Street 1:20072 SW BIRCH ST STE 210
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-0799
Practice Address - Country:US
Practice Address - Phone:949-270-6063
Practice Address - Fax:949-270-6064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-11
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases SpecialistGroup - Multi-Specialty