Healthcare Provider Details

I. General information

NPI: 1447214390
Provider Name (Legal Business Name): TRILOGY EYE MEDICAL GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2006
Last Update Date: 07/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44241 15TH ST W SUITE 201
LANCASTER CA
93534-5501
US

IV. Provider business mailing address

100 E CALIFORNIA BLVD
PASADENA CA
91105-3205
US

V. Phone/Fax

Practice location:
  • Phone: 661-949-5955
  • Fax: 661-949-5958
Mailing address:
  • Phone: 888-884-3805
  • Fax: 626-574-7188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. TOM S CHANG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 626-568-8838