Retina Institute of California Medical Group, a California Medical Par

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

RETINA INSTITUTE OF CALIFORNIA MEDICAL GROUP, A CALIFORNIA MEDICAL PAR

Practice address

1360 W 6TH St Ste 165
San Pedro, CA 90732-3540

Phone

(800) 898-2020

Fax

(949) 538-3938

NPI assigned

May 13, 2019

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, MD

Title

President

Phone

(800) 898-2020

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617062400000",
    "number": "1720644081",
    "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": "800-898-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 W 6TH ST STE 165",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907323540",
            "telephone_number": "800-898-2020",
            "fax_number": "949-538-3938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA INSTITUTE OF CALIFORNIA MEDICAL GROUP, A CALIFORNIA MEDICAL PAR",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-13",
        "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": "PRESIDENT",
        "authorized_official_telephone_number": "800-898-2020",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alfred Remijio
• Gina Remington, R.N.
• Neil D Remington, M.D.
• Renew Integrated Program-2 Incorporation
• Restoring Accountability
• Adrian Reveles, LCSW #112718
• Monica Reynoso
• Caroline June Rhee, PHARMD, RPH
• Riamd, Incorporation
• Alex Habib Riazati, PSYCHOLOGY TRAINEE

• Optometrist in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Optometrist 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.