NPIMap

Organization Active NPI

Eye Institute of California Medical Group Inc

  • Ophthalmology Physician
  • Chula Vista, CA
National Provider Identifier
1427059336
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
EYE INSTITUTE OF CALIFORNIA MEDICAL GROUP INC
Practice address
311 Del Mar Ave
Chula Vista, CA 91910-3908
Phone
(619) 427-3355
Fax
(619) 427-0955
NPI assigned
Aug 2, 2005
Last updated
Jan 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Authorized official

Name
David Joseph Goldman, MDNPI 1629185467
Title
Director
Phone
(619) 427-3355

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

311 Del Mar Ave
Chula Vista, CA 91910-3908

Mailing address

311 Del Mar Ave
Chula Vista, CA 91910-3908
Phone (619) 427-3355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050720000276 CA Part B Supplier - Clinic/Group Practice 3971530122 Receives reassigned benefits from 7 practitioners
Practice locations: Chula Vista, CA

National Provider Directory

National Provider Directory

Locations

311 Del Mar Ave
Chula Vista, CA 91910
Phone (619) 427-3355

480 Fourth Ave
Ste 201
Chula Vista, CA 91910
Phone (619) 427-3355

3405 Kenyon St
#M108
San Diego, CA 92110
Phone (619) 223-8177

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705449600000",
    "number": "1427059336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 DEL MAR AVE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919103908",
            "telephone_number": "619-427-3355",
            "fax_number": "619-427-0955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 DEL MAR AVE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919103908",
            "telephone_number": "619-427-3355",
            "fax_number": "619-427-0955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE INSTITUTE OF CALIFORNIA MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-02",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A",
        "authorized_official_last_name": "GOLDMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "619-427-3355",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.