San Gabriel Retina PC

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

Legal business name

SAN GABRIEL RETINA PC

Practice address

416 W Las Tunas Dr Ste 105
San Gabriel, CA 91776-1236

Phone

(626) 262-2082

Fax

(626) 317-8128

NPI assigned

Nov 19, 2018

Last updated

Nov 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Yi Jiang, MDNPI 1114210176

Title

President

Phone

(626) 262-2082

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

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.

• Yi Jiang, MD

  • Retina Specialist (Ophthalmology) Physician
  • San Gabriel, CA
  • NPI 1114210176
  Medicare reassignment Care Compare group NPD Authorized official
• George Zhang, MD

  • Ophthalmology Physician
  • San Gabriel, CA
  • NPI 1922561554
  Medicare reassignment Care Compare group NPD
• Bailey Yuguan Shen, MD

  • Retina Specialist (Ophthalmology) Physician
  • Loma Linda, CA
  • NPI 1316350739
  Medicare reassignment NPD

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

{
    "created_epoch": "1542585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730764800000",
    "number": "1891264818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 W LAS TUNAS DR STE 105",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761236",
            "telephone_number": "626-262-2082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 W LAS TUNAS DR STE 105",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761236",
            "telephone_number": "626-262-2082",
            "fax_number": "626-317-8128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN GABRIEL RETINA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-19",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A",
        "authorized_official_last_name": "JIANG",
        "authorized_official_first_name": "YI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-262-2082",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• San Gabriel Medical Investors, LLC (Life Care Center of San Gabriel)
• San Gabriel Medical Investors, LLC (Life Care Center of San Gabriel)
• San Gabriel Nephrology Services LLC (Quality Dialysis Center)
• San Gabriel Pharmacy Inc
• San Gabriel Post Acute LLC
• San Gabriel Unified School District
• San Gabriel Valley Consulting Pathologists Medical Group, Inc.
• San Gabriel Valley Eye Associates Inc
• San Gabriel Valley Foot and Ankle Clinic, Inc.
• San Gabriel Valley Medical Center

• Retina Specialist (Ophthalmology) Physician in San Gabriel, CA
• Providers in San Gabriel, CA by specialty
• Retina Specialist (Ophthalmology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.