# RETINA INSTITUTE OF CALIFORNIA MEDICAL GROUP

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

## Provider details

- **NPI number:** 1508474313
- **Authorized official:** TOM S CHANG MD (CEO, MANAGING PARTNER)
- **Authorized official phone:** (800) 898-2020

## Contact information

- **Practice address:** 5451 LA PALMA AVE STE 44, LA PALMA, CA 90623-1732
- **Practice address phone:** (800) 898-2020
- **Practice address fax:** (844) 897-3788
- **Mailing address:** 100 E CALIFORNIA BLVD, PASADENA, CA 91105-3205
- **Mailing address phone:** (800) 898-2020

## Taxonomy

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

## Other

- **Enumeration date:** 07/17/2020
- **Last updated:** 07/17/2020