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RETINA CONSULTANTS SAN DIEGO INC NPI 1790736098


NPI Information

NPI: 1790736098
Provider Name: RETINA CONSULTANTS SAN DIEGO INC
Classification: Ophthalmology - 207W00000X
Entity Type: Organization

CLIA Number: 05D2091515

Address:
12630 MONTE VISTA RD
SUITE 104
POWAY, CA
ZIP 92064
Phone: (858) 451-1911
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RETINA CONSULTANTS SAN DIEGO INC is an ophthalmology in Poway, CA. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. RETINA CONSULTANTS SAN DIEGO INC NPI is 1790736098. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

12630 MONTE VISTA RD
SUITE 104
POWAY, CA
ZIP 92064-526
Phone: (858) 451-1911
Fax: (858) 451-0566

The provider's authorized official is Paul Edward Tornambe .
The authorized official title is President and has the following contact phone number (858) 451-1911.

The CLIA number assigned to this NPI record is 05D2091515 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/12/2006 and was last updated on 1/29/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207W00000XOphthalmologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GR0045281MEDICAIDCALIFORNIA
2DA1466OTHERCALIFORNIAMEDICARE RAILROAD
3ZZZ30299ZOTHERCALIFORNIABLUE SHIELD
4W8585MEDICARE PINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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