# RETINA INSTITUTE OF CALIFORNIA MEDICAL GROUP, A CALIFORNIA MEDICAL PAR

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265825327
- **Authorized official:** DR. TOM S CHANG MD (OWNER)
- **Authorized official phone:** (626) 568-8838

## Contact information

- **Practice address:** 3816 WOODRUFF AVE, STE. 100, LONG BEACH, CA 90808-2145
- **Practice address phone:** (562) 424-0931
- **Practice address fax:** (562) 492-9400
- **Mailing address:** 100 E CALIFORNIA BLVD, PASADENA, CA 91105-3205
- **Mailing address phone:** (626) 568-8838
- **Mailing address fax:** (626) 583-8838

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | A69909 | CA | — |
| 174400000X | Specialist | A69909 | CA | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/13/2015
- **Last updated:** 07/19/2021