Unknown Individual – Ophthalmology Physician, NPI 1750358784

Ophthalmology Physician

Unknown Individual is a healthcare provider. based in Hemet, California. specializing in Ophthalmology Physician. They hold a License No. G19360 (CA). The NPI Number for Unknown Individual is 1750358784

Main info

Organization

Inactive

57 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1750358784

Phone

(951) 652-4343

Address

3953 W STETSON AVE

Deactivation Date

22 July 2022

Doctor Profile

Medical School Name

UNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE

Secondary Phone

7607285728

Graduation Year

1969 (57 years ago)

PAC ID

0648332585

Group Practice PAC ID

3375447964

Professional Enrollment ID

I20081231000011

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience14

Completeness75

Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

West Stetson Avenue, Hemet, Riverside County, California, 92543, United States
HEMET, CA 925459687
Phone: (951) 652-4343
Fax: (951) 765-6039
Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92545)

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Provider's Procedures

Unknown Individual performs procedures in Ophthalmology Physician. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
OPHTHALMOLOGY	CA	92083	Measurement of field of vision during daylight conditions	99	95

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 3375447964View full group profile

Name	Specialty	State
DR. ERIC CHIN (M.D.)	O P H T H A L M O L O G Y	CA
DR. ANGELA FAYE PERRY (M.D.)	O P H T H A L M O L O G Y	KS
SARA KHANDAN (MD)	-	FL
MR. ROGER DUNCAN JR. JOHNSON (M.D.)	O P H T H A L M O L O G Y	CA
DR. JEFFREY JOSEPH (M.D.)	O P H T H A L M O L O G Y	CA
MICHAEL J COOPER (OD)	O P T O M E T R Y	CA
DR. JOHN GRANT TEW (MD)	O P H T H A L M O L O G Y	CA
DR. JOHN PATRICK CARLSON (MD)	O P H T H A L M O L O G Y	CA
DR. BRETT ROBERT LARSON (O.D.)	O P T O M E T R Y	CA
DR. ROBERT C SORENSON (M.D., PH.D.)	O P H T H A L M O L O G Y	CA