Organization Active NPI

Retina Institute of California Medical Group, a California Medical Par

  • Ophthalmology Physician
  • National City, CA
National Provider Identifier
1295238582
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
RETINA INSTITUTE OF CALIFORNIA MEDICAL GROUP, A CALIFORNIA MEDICAL PAR
Practice address
2240 E Plaza Blvd Ste F
National City, CA 91950-5165
Phone
(619) 470-2700
Fax
(619) 236-7822
NPI assigned
Mar 13, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Authorized official

Name
Tom S Chang, MD
Title
Founder
Phone
(626) 568-8833

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

2240 E Plaza Blvd Ste F
National City, CA 91950-5165

Mailing address

100 E California Blvd
Pasadena, CA 91105-3205
Phone (626) 568-8838

National Provider Directory

National Provider Directory

Locations

2240 E Plaza Blvd
Ste F
National City, CA 91950
Phone (619) 470-2700

NPI Registry JSON

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

{
    "created_epoch": "1520899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617062400000",
    "number": "1295238582",
    "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": "2240 E PLAZA BLVD STE F",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919505165",
            "telephone_number": "619-470-2700",
            "fax_number": "619-236-7822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA INSTITUTE OF CALIFORNIA MEDICAL GROUP, A CALIFORNIA MEDICAL PAR",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-13",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "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": "626-568-8833",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in National City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.