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General NPI Number Information
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NPI Number | 1265989347
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Entity Type | Organization
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Legal Business Name | TRILOGY EYE MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 09/06/2016
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Last Update Date | 09/06/2016
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Provider Practice Location Address
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Address Line | 18340 YORBA LINDA BLVD SUITE 108
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City | YORBA LINDA
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State | CA
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Zip | 92886-4058
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Country | US
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Telephone | 714-577-6031
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Fax | 626-796-7657
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Provider Business Mailing Address
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Address Line | 100 E CALIFORNIA BLVD
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City | PASADENA
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State | CA
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Zip | 91105-3205
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Country | US
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Telephone | 888-884-3805
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Fax | 626-796-7657
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Authorized Official
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Title or Position | FOUNDER
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Name | DR. TOM S. CHANG
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Credential | M.D.
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Telephone | 626-568-8838
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State | CA
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