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Trilogy Eye Medical Group, Inc.

Organization Active NPI Specialist · San Gabriel, CA

NPI 1235570607 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1235570607
Entity type
Organization (NPI type 2)
Primary specialty
Specialist 174400000X
Legal business name
TRILOGY EYE MEDICAL GROUP, INC.
Practice address
207 S Santa Anita Ave
Suite P-25
San Gabriel, CA 91776-1146
Phone
(626) 269-5355
Fax
(626) 284-8448
NPI assigned
Jul 12, 2013
Organization subpart
No

Authorized official

Name
Dr. Tom S Chang, MD
Title
Founder/Owner
Phone
(626) 289-2223

Corporate family (same tax ID) 32

Organizations that report the same tax identification number in the National Provider Directory.

View all 32

National Provider Directory

Tax ID family
Trilogy Eye Medical Group Inc (33 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X SINGLE SPECIALTY GROUP		 152W00000X CA
Specialist
Group: 193200000X MULTI-SPECIALTY GROUP		 174400000X CA Yes
Ophthalmology Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207W00000X
Retina Specialist (Ophthalmology) Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207WX0107X CA

Addresses

Primary practice location

207 S Santa Anita Ave
Suite P-25
San Gabriel, CA 91776-1146

Mailing address

100 E California Blvd
Pasadena, CA 91105-3205
Phone (626) 269-5371

Other identifiers

IdentifierTypeStateIssuer
FQ161AOtherCAMCR(S)
FQ161BOtherCAMCR(N)
1114205432MedicaidCA

Other names

  • ACUITY EYE SPECIALISTS Doing business as
  • CALIFORNIA EYE AND EAR SPECIALISTS Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 21, 2022.

{
    "created_epoch": "1373587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1235570607",
    "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": "626-269-5371",
            "fax_number": "626-577-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 S SANTA ANITA AVE",
            "address_2": "SUITE P-25",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761146",
            "telephone_number": "626-269-5355",
            "fax_number": "626-284-8448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRILOGY EYE MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-12",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "TOM",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "FOUNDER/OWNER",
        "authorized_official_telephone_number": "626-289-2223",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCR(S)",
            "identifier": "FQ161A",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCR(N)",
            "identifier": "FQ161B",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114205432",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ACUITY EYE SPECIALISTS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CALIFORNIA EYE AND EAR SPECIALISTS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Gabriel, CA

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Sources for this page

Verify at the official NPI Registry.