# 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:** 1336641034
- **Authorized official:** TOM S CHANG (FOUNDER)
- **Authorized official phone:** (626) 568-8833

## Contact information

- **Practice address:** 300 S PIERCE ST \# 200, EL CAJON, CA 92020-4124
- **Practice address phone:** (619) 440-5400
- **Practice address fax:** (619) 440-0239
- **Mailing address:** 288 N SANTA ANITA AVE STE 402, ARCADIA, CA 91006-3183
- **Mailing address phone:** (800) 898-2020
- **Mailing address fax:** (844) 897-3788

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/08/2018
- **Last updated:** 10/13/2023