Organization
TRILOGY EYE MEDICAL GROUP, INC
Active
Other names
ACUITY EYE SPECIALISTS, CALIFORNIA EYE AND EAR SPECIALISTS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TOM S CHANG MD (FOUNDER/OWNER)
(800) 898-2020
Entity
Organization
Contact information
Practice address
2400 N BROADWAY, LOS ANGELES, CA 90031-2219
(323) 221-8000
(323) 221-0738
Mailing address
100 E CALIFORNIA BLVD, PASADENA, CA 91105-3205
(626) 574-0020
(626) 574-7188
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
174400000X
Specialist
—
CA
207W00000X
Ophthalmology Physician
Primary
—
—
207WX0107X
Retina Specialist (Ophthalmology) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114205432
—
CA
01
—
FQ161A
MCR(S)
CA
01
—
FQ161B
MCR(N)
CA
Enumeration date
09/04/2013
Last updated
07/21/2022
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