RETINA INSTITUTE OF CALIFORNIA MEDICAL GROUP (NPI# 1831582998) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831582998 |
| Entity Type | Organization |
| Organization Name | RETINA INSTITUTE OF CALIFORNIA MEDICAL GROUP |
| Practice Address |
11525 Brookshire Ave 210a Downey CA 90241-4985 |
| Mailing Address |
100 E California Blvd Pasadena CA 91105-3205 |
| Practice Telephone | 5628626200 |
| Practice Fax Number | 5628626233 |
| 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 |
11525 BROOKSHIRE AVE 210A |
| City | DOWNEY |
| State | CA |
| Zip Code | 90241-4985 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306816657 | Douglas A Blose | Dermatology | 11525 Brookshire Ave, Downey, CA 90241-4985 | 2006-01-26 |
| 1932748126 | Bo Cho | Acupuncturist | 11525 Brookshire Ave, Downey, CA 90241-4985 | 2020-01-05 |
| 1710358395 | Phillip Boggs | Nurse Practitioner | 11525 Brookshire Ave, Suite 400, Downey, CA 90241-4985 | 2015-10-08 |
| 1487075735 | Pallavi Kasukurthi | Internal Medicine | 11525 Brookshire Ave, Suite 400, Downey, CA 90241-4985 | 2014-01-03 |
| 1164760948 | Applecare Medical Group, Inc. | Non-Pharmacy Dispensing Site | 11525 Brookshire Ave, 400, Downey, CA 90241-4985 | 2013-01-29 |
| 1821370040 | Sharon George | Hospitalist | 11525 Brookshire Ave, #400, Downey, CA 90241-4985 | 2011-09-14 |
| 1215230297 | J. Bruce Jacobs, Md, Inc | Radiology | 11525 Brookshire Ave, Suite 111, Downey, CA 90241-4985 | 2010-12-13 |
| 1558683037 | Victoria Anna Reyman | Nurse Practitioner | 11525 Brookshire Ave, Suite 301, Downey, CA 90241-4985 | 2010-02-24 |
| 1083840367 | Raj Balasundaram | Internal Medicine | 11525 Brookshire Ave, Suite 400, Downey, CA 90241-4985 | 2009-06-01 |
| 1659518355 | Vance C Eberly Md Inc | Specialist | 11525 Brookshire Ave, Suite 405, Downey, CA 90241-4985 | 2009-01-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164029005 | Adam Lyle Barnhardt | Counselor | 11500 Paramont Blvd., Downey, CA 90241 | 2020-10-05 |
| 1922630482 | Betzabeth Benitez Perez | Counselor | Scadp, 11500 Paramount Blvd., Downey, CA 90241 | 2020-02-12 |
| 1457858714 | Diane Padre-gozun | Student in an Organized Health Care Education/Training Program | 11500 Brookshire Ave, Gme Office, Downey, CA 90241 | 2018-04-12 |
| 1295233963 | Community Family Guidance Center | Community/Behavioral Health | 12330 Woodruff Ave, Downey, CA 90241 | 2018-01-29 |
| 1487167433 | Progressive Medical Associates | Health Maintenance Organization | 6611 Seville Avenue, Huntington Park, CA 90241 | 2017-11-13 |
| 1194236018 | Dental Office of Downey Inc. | Clinic/Center | 10917 Paramounth Blvd, Downey, CA 90241 | 2017-10-18 |
| 1376063933 | Sophea Tim | Pharmacist | 11525 Brookshire Avenue Suite 400, Downey, CA 90241 | 2017-06-26 |
| 1952835282 | Dr. Jose Flores D.d.s Inc. | Preferred Provider Organization | 11510 Downey Ave, Downey, CA 90241 | 2017-04-13 |
| 1053844043 | Stephen Nealon Berberich | Internal Medicine | 1544 Downey Ave, Downey, CA 90241 | 2017-04-06 |
| 1225424187 | Davis Huang | Internal Medicine | 11500 Brookshire Ave., Downey, CA 90241 | 2015-04-07 |
| Find all providers in zip 90241 | ||||
| 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 |
|---|---|---|---|---|
| 1659815496 | Jennifer C Joswick | Specialist | 8615 Florence Ave Ste 212, Downey, CA 90240-4037 | 2016-12-13 |
| 1427398106 | National Billing and Management LLC | Specialist | 9414 Firestone Blvd, Downey, CA 90241 | 2013-02-18 |
| 1093059180 | Mvp Family Practice & Sports Medicine, Inc | Specialist | 8207 3rd St Ste 205, Downey, CA 90241-3731 | 2012-11-15 |
| 1003145764 | One Stop Multi-specialty Medical Group, Inc. | Specialist | 8607 Imperial Hwy Ste 109, Downey, CA 90242-3947 | 2009-12-09 |
| 1538309067 | Francisco Jose Recalde | Specialist | 1116 Rives Ave, Downey, CA 90241 | 2009-02-24 |
| 1881899391 | Prentice Mitri & Hijazin | Specialist | 10916 Downey Ave, Downey, CA 90241-3709 | 2007-06-15 |
| 1285837120 | Walter S Green, M.d. Medical Corporation | Specialist | 8345 Firestone Blvd Ste 310, Downey, CA 90241-3872 | 2007-06-07 |
| 1558446476 | Michael C Buchbinder | Specialist | 11546 Downey Ave, Downey, CA 90241-4955 | 2006-10-26 |
| 1356425888 | Downey Dermatologic Medical Group Inc | Specialist | 11480 Brookshire Ave Ste 109, Downey, CA 90241-5022 | 2006-10-24 |
| 1194769232 | Phuong Catherine Truong-yue | Specialist | 8500 Florence Ave Fl 2, Downey, CA 90240-4056 | 2006-06-16 |
| Find all providers in DOWNEY | ||||
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| 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.