Retina Institute of California Medical Group, a California Medical Par

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

RETINA INSTITUTE OF CALIFORNIA MEDICAL GROUP, A CALIFORNIA MEDICAL PAR

Practice address

1620 Alpine Blvd Ste 117
Alpine, CA 91901-1103

Phone

(619) 455-2687

Fax

(619) 445-0801

NPI assigned

Mar 8, 2018

Organization subpart

No

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

Authorized official

Name

Tom S Chang

Title

Founder

Phone

(626) 568-8833

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1520467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617062400000",
    "number": "1689176380",
    "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": "1620 ALPINE BLVD STE 117",
            "city": "ALPINE",
            "state": "CA",
            "postal_code": "919011103",
            "telephone_number": "619-455-2687",
            "fax_number": "619-445-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA INSTITUTE OF CALIFORNIA MEDICAL GROUP, A CALIFORNIA MEDICAL PAR",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-08",
        "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"
    },
    "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": []
}

• Kate Nelly Rasmuzzen, RDH
• Jennifer Rauch, LCSW
• Rachel Raver, PH.D.
• Gavva Ranadhir Ram Reddy, MD
• Christina Reed, M.D.
• Cynthia Araceli Reyes
• Jordan Elizabeth Rice, CERTIFIED
• Dawn Tanya Roberts, D.C.
• Robin C. Robinson-Gary, RN, FNP-BC
• Gabrielle Roden, DPT

• Ophthalmology Physician in Alpine, CA
• Providers in Alpine, CA by specialty
• Ophthalmology Physician in California

• 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.