Retina Institute of California Medical Group

Primary specialty

SpecialistTaxonomy code 174400000X

License

A69909 Issued in CA

Legal business name

RETINA INSTITUTE OF CALIFORNIA MEDICAL GROUP

Practice address

44139 Monterey Ave
Suite a
Palm Desert, CA 92260-8700

Phone

(760) 779-0800

Fax

(760) 779-0801

NPI assigned

Mar 12, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Tom S. Chang, M.D.

Title

Founder

Phone

(626) 568-8838

Specialties & licenses 2

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tarek Alasil, MD

  • Retina Specialist (Ophthalmology) Physician
  • Los Angeles, CA
  • NPI 1003072786
  NPD (past)
• Jeffrey Lyle Stevens, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Pasadena, CA
  • NPI 1114254711
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1426118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426118400000",
    "number": "1104219286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E CALIFORNIA BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053205",
            "telephone_number": "626-568-8838",
            "fax_number": "626-574-7188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44139 MONTEREY AVE",
            "address_2": "SUITE A",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922608700",
            "telephone_number": "760-779-0800",
            "fax_number": "760-779-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA INSTITUTE OF CALIFORNIA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-12",
        "last_updated": "2015-03-12",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "TOM",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "626-568-8838",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "A69909",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A69909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1760541569",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reliance Hospice, Inc.
• Reliance Hospice, Inc.
• Tong Ren
• Renaissance ASC, LLC
• Carol Renke, MD
• Retina Institute of California Medical Group
• Retina Institute of California Medical Group, a California Medical Par
• Jennifer Reyes Rivas
• Lolita Bruch Reyes-Montoya, PA-C
• Carla Reynolds, R.N.

• Specialist in Palm Desert, CA
• Providers in Palm Desert, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.