Southern California Desert Retina Consultants

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

SOUTHERN CALIFORNIA DESERT RETINA CONSULTANTS

Practice address

36949 Cook St Ste 101
Palm Desert, CA 92211-6080

Phone

(760) 340-2394

Fax

(760) 340-2369

NPI assigned

Jun 12, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Clement K. Chan, DOCTOR

Title

President

Phone

(760) 340-2394

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Inland Retina Consultants Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

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

• Maziar Lalezary, MD

  • Retina Specialist (Ophthalmology) Physician
  • Beverly Hills, CA
  • NPI 1710170253

  Single Specialty

  NPD (past)
• Asha S.D. Nuthi, D.O.

  • Retina Specialist (Ophthalmology) Physician
  • Oceanside, CA
  • NPI 1851393243
  NPD (past)
• Dariusz George Tarasewicz, MD

  • Ophthalmology Physician
  • Sacramento, CA
  • NPI 1932288073
  NPD (past)
• Sharon M Theodore, M.D.

  • Ophthalmology Physician
  • Pismo Beach, CA
  • NPI 1831145739
  NPD (past)
• David M Salib, MD

  • Ophthalmology Physician
  • Norfolk, VA
  • NPI 1053367946
  NPD (past)

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600992000000",
    "number": "1659313997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36949 COOK ST STE 101",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922116080",
            "telephone_number": "760-340-2394",
            "fax_number": "760-340-2369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36949 COOK ST STE 101",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922116080",
            "telephone_number": "760-340-2394",
            "fax_number": "760-340-2369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "340 S Farrell Dr Ste A105",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "CA",
            "postal_code": "922627921",
            "country_code": "US",
            "telephone_number": "760-327-6225",
            "fax_number": "760-325-8333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6216 Brockton Ave Ste 214",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925062223",
            "country_code": "US",
            "telephone_number": "951-686-1190",
            "fax_number": "951-686-1191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA DESERT RETINA CONSULTANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "CLEMENT",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-340-2394",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DOCTOR"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0069070",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0069073",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0069072",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Inland Retina Consultants",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Inland Retina Consultants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Soniya Patidar DMD PC
• Michelle Soos, B.S., M.A., SLP-CCC
• Myles Soriano, PHARM.D.
• Lisbet Sosa Pliego
• Evangelina Sosa
• Jacob Spencer, D.O.
• Peter S. Spiegel, M.D.
• Spine & Sport Clinic
• St. Marypt Corp
• Elizabeth Stankis, R.D.

• Ophthalmology Physician in Palm Desert, CA
• Providers in Palm Desert, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.