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

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1770976987
- **Authorized official:** DR. TOM S CHANG (FOUNDER)
- **Authorized official phone:** (626) 568-8838

## Contact information

- **Practice address:** 6906 BROCKTON AVE, STE. 6, RIVERSIDE, CA 92506-4090
- **Practice address phone:** (951) 784-8373
- **Practice address fax:** (951) 784-8377
- **Mailing address:** 100 E CALIFORNIA BLVD, PASADENA, CA 91105-3205
- **Mailing address phone:** (626) 568-8838
- **Mailing address fax:** (626) 574-7188

## 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:** 03/12/2015
- **Last updated:** 10/08/2021