# CENTER FOR RETINAL AND MACULAR DISEASES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Center for Retinal and Macular Diseases
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265661821
- **Authorized official:** LEONID E. LERNER M.D., PH.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (949) 500-3207

## Contact information

- **Practice address:** 1440 AVOCADO AVENUE, SUITE 204, NEWPORT BEACH, CA 92660
- **Practice address phone:** (949) 721-1701
- **Practice address fax:** (949) 612-1910
- **Mailing address:** 1441 AVOCADO AVE, SUITE 204, NEWPORT BEACH, CA 92660-7721
- **Mailing address phone:** (949) 500-3207
- **Mailing address fax:** (949) 612-1910

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | A54458 | CA | Yes |

## Other

- **Enumeration date:** 07/04/2009
- **Last updated:** 05/01/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | CT593A | MEDICARE PTAN | CA |
| 01 | — | CT593B | MEDICARE PTAN | CA |