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Organization
TRILOGY EYE MEDICAL GROUP, INC.
Active
Organization
TRILOGY EYE MEDICAL GROUP, INC.
Active
Other names
ACUITY EYE SPECIALISTS
Organization subpart
No
Provider details
NPI number
Authorized official
TOM S CHANG MD (OWNER)
(626) 568-8838
Entity
Organization
Contact information
Practice address
47474 WASHINGTON ST, LA QUINTA, CA 92253-8846
(760) 564-2500
(760) 564-2577
Mailing address
100 E CALIFORNIA BLVD, PASADENA, CA 91105-3205
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
174400000X
Specialist
—
CA
207W00000X
Ophthalmology Physician
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114205432
—
CA
01
—
FQ161A
MCR(S)
CA
01
—
FQ161B
MCR(N)
CA
Enumeration date
03/16/2017
Last updated
04/01/2019
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