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Organization
RETINA INSTITUTE OF CALIFORNIA MEDICAL GROUP
Active
Organization
RETINA INSTITUTE OF CALIFORNIA MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TOM S CHANG MD (FOUNDER)
(626) 568-8838
Entity
Organization
Contact information
Practice address
500 S ANAHEIM HILLS RD STE 234, ANAHEIM, CA 92807-4760
(714) 921-0232
(714) 921-0535
Mailing address
100 E CALIFORNIA BLVD, PASADENA, CA 91105-3205
(626) 568-8838
(626) 574-7188
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
03/12/2015
Last updated
11/03/2021
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