Organization
RETINA INSTITUTE OF CALIFORNIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOM S CHANG MD (FOUNDER)
(800) 898-2020
Entity
Organization
Contact information
Practice address
5565 GROSSMONT CENTER DR # 2-3, LA MESA, CA 91942-3020
(619) 697-4600
(619) 445-5526
Mailing address
100 E CALIFORNIA BLVD, PASADENA, CA 91105-3205
(626) 568-8838
(626) 583-8838
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760541569
—
CA
Enumeration date
07/21/2017
Last updated
07/21/2022
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