Organization · NPI-2

Retina Institute Of California Medical Group, A California Medical Par

Optometrist · Indio, CA

NPI number1679249676
StatusActive
Last updated in NPPESOct 26, 2021

Details

NPI
1679249676
Entity type
Organization (NPI-2)
Legal business name
Retina Institute Of California Medical Group, A California Medical Par
Organization subpart
No
Enumeration date
Aug 19, 2021
Certification date
Oct 26, 2021
Last updated
Oct 26, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
152W00000X Optometrist––Yes
207W00000X Ophthalmology––

Other names

  • Acuity Optical (Doing Business As)

Practice location

81952 Us Highway 111
Suite B, C, D
Indio, CA 92201-9716

Phone 442-300-9209 · Fax 442-300-9266

Mailing address

100 E California Blvd
Pasadena, CA 91105-3205

Phone 800-898-2020

Authorized official

Tom S Chang
Ceo, Managing Partner
8008982020

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