RETINA INSTITUTE OF CALIFORNIA MEDICAL GROUP (NPI# 1700279866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700279866 |
| Entity Type | Organization |
| Organization Name | RETINA INSTITUTE OF CALIFORNIA MEDICAL GROUP |
| Practice Address |
3545 Wilshire Blvd 214 Los Angeles CA 90010-2354 |
| Mailing Address |
100 E California Blvd Pasadena CA 91105-3205 |
| Practice Telephone | 2133896040 |
| Practice Fax Number | 2133896030 |
| Mailing Telephone | 6265688838 |
| Mailing Fax Number | 6265747188 |
| Enumeration Date | 2015-03-13 |
| Last Update Date | 2015-03-13 |
| Authorized Official Name | DR. TOM S CHANG (FOUNDER) |
| Authorized Official Telephone | 6265688838 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | A69909 | CA | Eye and Vision Services Providers |
| Y | 174400000X | Specialist | A69909 | CA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GROUP NPI | 1760541569 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558826586 | Retina Institute of California Medical Group | Optometrist | 225 W Madison Ave Ste 1, El Cajon, CA 92020-3454 | 2019-02-04 |
| 1447715479 | Retina Institute of California Medical Group | Optometrist | 320 Santa Fe Dr Ste 104, Encinitas, CA 92024-5139 | 2019-02-04 |
| 1083007140 | Retina Institute of California Medical Group | Optometrist | 2423 N Broadway, Los Angeles, CA 90031-2218 | 2015-03-13 |
| 1124411285 | Retina Institute of California Medical Group | Optometrist | 14642 Newport Ave Ste 350, Tustin, CA 92780-6091 | 2015-03-13 |
| 1588057640 | Retina Institute of California Medical Group | Optometrist | 325 E. Rolling Oaks Drive, 130, Thousand Oaks, CA 91361-1201 | 2015-03-13 |
| 1912390097 | Retina Institute of California Medical Group | Optometrist | 47474 Washington St, La Quinta, CA 92253-8846 | 2015-03-12 |
| 1467845545 | Retina Institute of California Medical Group | Optometrist | 12828 Harbor Blvd Ste 305, Garden Grove, CA 92840-5835 | 2015-03-12 |
| 1508474313 | Retina Institute of California Medical Group | Optometrist | 5451 La Palma Ave Ste 44, La Palma, CA 90623-1732 | 2020-07-17 |
| 1003449604 | Retina Institute of California Medical Group | Ophthalmology | 9834 Genesee Ave Ste 428, La Jolla, CA 92037-1264 | 2020-02-21 |
| 1245878784 | Retina Institute of California Medical Group | Optometrist | 9850 Genesee Ave Ste 310, La Jolla, CA 92037-1208 | 2019-12-16 |
| Street Address |
3545 WILSHIRE BLVD 214 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90010-2354 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184661316 | Wilshire Joeun Medical Group, Inc | Family Medicine | 3545 Wilshire Blvd, 202, Los Angeles, CA 90010-2354 | 2006-05-31 |
| 1942675657 | Kenneth Kritboonyalai | Occupational Therapy Assistant | 3545 Wilshire Blvd, Los Angeles, CA 90010-2354 | 2015-12-07 |
| 1679983415 | Young Sil Ahn | Acupuncturist | 3545 Wilshire Blvd, 300, Los Angeles, CA 90010-2354 | 2014-05-01 |
| 1932452026 | Park & Park Chiropractic Apc | Chiropractor | 3545 Wilshire Blvd, #203, Los Angeles, CA 90010-2354 | 2012-10-26 |
| 1174873392 | Kc Family Acupuncture Inc | Acupuncturist | 3545 Wilshire Blvd, #208, Los Angeles, CA 90010 | 2012-09-14 |
| 1861751810 | Jonah Medical Group | Non-Pharmacy Dispensing Site | 3545 Wilshire Blvd, 202, Los Angeles, CA 90010-2354 | 2012-05-11 |
| 1235498718 | Vanguard Medical Group Inc | General Practice | 3545 Wilshire Blvd, #340, Los Angeles, CA 90010-2354 | 2012-05-03 |
| 1750607818 | Ben Park | Pharmacy Technician | 3545 Wilshire Blvd, #200, Los Angeles, CA 90010-2354 | 2010-04-14 |
| 1740506815 | Nayoung Kim | Pharmacy Technician | 3545 Wilshire Blvd, Suit #200, Los Angeles, CA 90010-2354 | 2010-04-14 |
| 1881854347 | Esther You Jun | Acupuncturist | 3545 Wilshire Blvd, 208, Los Angeles, CA 90010-2354 | 2008-06-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205454204 | Sage Minds | Psychiatry & Neurology | 3860 Wilshire Blvd, P04-1188, Los Angeles, CA 90010 | 2020-07-07 |
| 1629602750 | Shalva, A Psychology Corporation | Counselor | 4221 Wilshire Boulevlard, Suite 170b, Los Angeles, CA 90010 | 2020-02-27 |
| 1609346287 | Leticia Arteaga | Marriage & Family Therapist | 3580 Wilshire Blvd Suite 800, Los Angeles, CA 90010 | 2018-11-27 |
| 1891265559 | Maria Nguyen | Case Manager/Care Coordinator | 3424 Wilshire Blvd Ste 1000, Los Angeles, CA 90010 | 2018-11-26 |
| 1568955474 | Cherie Emi Okada | Student in an Organized Health Care Education/Training Program | 358 Wilshire Blvd, Suite 2000, Los Angeles, CA 90010 | 2018-06-14 |
| 1780101832 | Bj Park, Chiropractic | Acupuncturist | 3020 Wilshire Blvd., Suite 220, Los Angeles, CA 90010 | 2017-08-29 |
| 1952828188 | Karin Alm | Case Manager/Care Coordinator | 3580 Wilshire Blvd., Suite 2000, Los Angeles, CA 90010 | 2017-08-28 |
| 1295257111 | Freddy Pablo | Rehabilitation Practitioner | 3580 Wilshire Blvd., Ste. 800, Los Angeles, CA 90010 | 2017-07-12 |
| 1770032690 | Astghik Harutyunyan | Special Hospital | 3699 Wilshire Blve, Los Angeles, CA 90010 | 2016-10-04 |
| 1629446281 | Praveena Chinniah | Behavioral Analyst | 4221 Wilshire Blvd., Suite 300a, Los Angeles, CA 90010 | 2015-09-11 |
| Find all providers in zip 90010 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255801098 | Maria Elizabeth Botham | Specialist | 8250 W 3rd St Ste 203, Los Angeles, CA 90048-4327 | 2018-12-04 |
| 1154899821 | Adam Garcia-morales | Specialist | 216 S Townsend Ave, Los Angeles, CA 90063-2439 | 2018-11-11 |
| 1174028930 | Sabrena Anne Smith | Specialist | 1680 Vine St Ste 908, Los Angeles, CA 90028-8838 | 2018-03-26 |
| 1538663513 | John Horton | Specialist | 760 Westwood Plaza, Resident Office, Los Angeles, CA 90024 | 2018-03-22 |
| 1598272262 | Ronna Lynne Pearl | Specialist | 3371 Glendale Blvd Ste 215, Los Angeles, CA 90039-1857 | 2018-01-04 |
| 1245754431 | Marla Ellen Mintz | Specialist | 11844 W Pico Blvd Ste 200, Los Angeles, CA 90064-1353 | 2017-07-28 |
| 1730619818 | Emily Ng | Specialist | 8590 W Pico Blvd, Los Angeles, CA 90035-2691 | 2017-06-12 |
| 1871044297 | Katherinne Aucaruri | Specialist | 4225 Blanchard St, Los Angeles, CA 90063-1317 | 2016-10-20 |
| 1720536923 | Jkc Neurology Medical Group Inc | Specialist | 3550 Wilshire Blvd Ste 650, Los Angeles, CA 90010-2440 | 2016-09-15 |
| 1932552916 | Anthony Jose Salvatierra | Specialist | 421 S Manhattan Pl Apt 9, Los Angeles, CA 90020-4175 | 2016-07-14 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90010 |
Please comment or provide details below to improve the information on RETINA INSTITUTE OF CALIFORNIA MEDICAL GROUP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.