Organization
TRILOGY EYE MEDICAL GROUP, INC.
Active
Other names
ACUITY EYE SPECIALISTS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TOM S. CHANG MD (FOUNDER/ OWNER)
(626) 568-8838
Entity
Organization
Contact information
Practice address
1620 ALPINE BLVD STE 117, ALPINE, CA 91901-1103
(619) 445-2687
(619) 445-0801
Mailing address
100 E CALIFORNIA BLVD, PASADENA, CA 91105-3205
(626) 269-5371
(626) 577-2100
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
CA
174400000X
Specialist
—
CA
207W00000X
Ophthalmology Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114205432
—
CA
01
—
FQ161A
MCR (S)
CA
01
—
FQ161B
MCR (N)
CA
Enumeration date
09/26/2017
Last updated
09/26/2017
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