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Organization
RETINA INSTITUTE OF CALIFORNIA MEDICAL GROUP, A CALIFORNIA MEDICAL PAR
Active
Organization
RETINA INSTITUTE OF CALIFORNIA MEDICAL GROUP, A CALIFORNIA MEDICAL PAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TOM S CHANG MD (OWNER)
(626) 568-8838
Entity
Organization
Contact information
Practice address
3816 WOODRUFF AVE, STE. 100, LONG BEACH, CA 90808-2145
(562) 424-0931
(562) 492-9400
Mailing address
100 E CALIFORNIA BLVD, PASADENA, CA 91105-3205
(626) 568-8838
(626) 583-8838
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
A69909
CA
174400000X
Specialist
A69909
CA
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
03/13/2015
Last updated
07/19/2021
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