Organization
RETINAL DIAGNOSTIC CENTER A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIM KELLEY (OFFICE MANAGER)
(408) 559-0666
Entity
Organization
Contact information
Practice address
3395 S. BASCOM AVE., SUITE 140, CAMPBELL, CA 95008
(408) 559-0666
(408) 963-5920
Mailing address
3395 S. BASCOM AVE., SUITE 140, CAMPBELL, CA 95008
(408) 559-0666
(408) 963-5920
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A538890
—
CA
05
—
00C370860
—
CA
05
—
00G607230
—
CA
05
—
00G838240
—
CA
Enumeration date
11/16/2006
Last updated
11/18/2025
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