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General NPI Number Information
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NPI Number | 1023992641
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Entity Type | Organization
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Legal Business Name | RETINA INSTITUTE PC
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 30200 AGOURA RD STE 140
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City | AGOURA HILLS
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State | CA
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Zip | 91301-5426
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Country | US
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Telephone | 747-247-8400
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Fax | 747-247-8111
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Provider Business Mailing Address
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Address Line | 30200 AGOURA RD STE 140
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City | AGOURA HILLS
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State | CA
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Zip | 91301-5426
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Country | US
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Telephone | 747-247-8400
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Fax | 747-247-8111
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Authorized Official
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Title or Position | OWNER
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Name | MOISES ENGHELBERG
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Credential | DO
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Telephone | 954-701-3912
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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