| Trilogy Eye Medical Group Inc | |
|
100 E California Blvd, Pasadena, CA 91105-3205 | |
| (626) 568-8838 | |
| (626) 796-7657 |
| Full Name | Trilogy Eye Medical Group Inc |
|---|---|
| Type | Facility |
| Speciality | Ophthalmology |
| Location | 100 E California Blvd, Pasadena, California |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114205432 | NPI | - | NPPES |
| 1114205432 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (California) | Secondary |
| 207WX0107X | Ophthalmology - Retina Specialist | (California) | Secondary |
| 207W00000X | Ophthalmology | (California) | Primary |
| Provider Name | Michael A Samuel |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1730175670 PECOS PAC ID: 7315910858 Enrollment ID: I20040813000731 |
| Provider Name | Phuc Quach |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1770617805 PECOS PAC ID: 5294755195 Enrollment ID: I20051206000643 |
| Provider Name | Richard V Packard |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1942358320 PECOS PAC ID: 2961424452 Enrollment ID: I20051227000641 |
| Provider Name | Tom S Chang |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1609848969 PECOS PAC ID: 7113931056 Enrollment ID: I20060201000549 |
| Provider Name | Jeffrey P Wasserstrom |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1710922687 PECOS PAC ID: 7012911290 Enrollment ID: I20060830000314 |
| Provider Name | Paul M Bonds |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1346320645 PECOS PAC ID: 1355440934 Enrollment ID: I20070621000756 |
| Provider Name | Bruce T Haight |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1427029628 PECOS PAC ID: 9032289897 Enrollment ID: I20080605000207 |
| Provider Name | Anthony Culotta |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1497790018 PECOS PAC ID: 5991878332 Enrollment ID: I20090326000464 |
| Provider Name | Michael R Rose |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1861593006 PECOS PAC ID: 9335176668 Enrollment ID: I20100209000695 |
| Provider Name | Kristie Lin |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1184801557 PECOS PAC ID: 2365506425 Enrollment ID: I20110726000291 |
| Provider Name | Kevin K Suk |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1326257569 PECOS PAC ID: 4688711187 Enrollment ID: I20110822000424 |
| Provider Name | Reid Wainess |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1396935979 PECOS PAC ID: 9638340524 Enrollment ID: I20110926000815 |
| Provider Name | Evelyn M Perez |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1124101084 PECOS PAC ID: 3274792007 Enrollment ID: I20120313000941 |
| Provider Name | Martha Patricia Buckley |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1376844993 PECOS PAC ID: 5395900781 Enrollment ID: I20120710000605 |
| Provider Name | Lily F Lee |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1730311226 PECOS PAC ID: 0143478495 Enrollment ID: I20120912000324 |
| Provider Name | Murtaza Merali |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1972944189 PECOS PAC ID: 9133353089 Enrollment ID: I20131008000401 |
| Provider Name | Jessica M Boeckmann |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1629210679 PECOS PAC ID: 9234364464 Enrollment ID: I20131024001166 |
| Provider Name | Kweku Grant-acquah |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1831327626 PECOS PAC ID: 2264667294 Enrollment ID: I20131029002250 |
| Provider Name | Marineh Baghoumian |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1972929438 PECOS PAC ID: 5294950796 Enrollment ID: I20140625001021 |
| Provider Name | Juliane Lee |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1780890749 PECOS PAC ID: 0143445551 Enrollment ID: I20140626002608 |
| Provider Name | Brian H Chen |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1952631632 PECOS PAC ID: 9335365501 Enrollment ID: I20140723002578 |
| Provider Name | Ling Y Bei |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1164740460 PECOS PAC ID: 4789813361 Enrollment ID: I20140828000101 |
| Provider Name | Dana Le |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285030015 PECOS PAC ID: 1153645379 Enrollment ID: I20150117000082 |
| Provider Name | Grace T Chi |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1366607558 PECOS PAC ID: 4880759471 Enrollment ID: I20150130001992 |
| Provider Name | Wesley S Chew |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1952714446 PECOS PAC ID: 4385969708 Enrollment ID: I20150205002646 |
| Provider Name | Heidrun Elisabeth Gollogly |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1477879823 PECOS PAC ID: 0648449157 Enrollment ID: I20150508000732 |
| Provider Name | Avneet Kaur Sodhi-gaur |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1982929105 PECOS PAC ID: 9739306614 Enrollment ID: I20150819006484 |
| Provider Name | Anuj Chawla |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1083841027 PECOS PAC ID: 0244458024 Enrollment ID: I20150824002631 |
| Provider Name | Henry V Tran |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467846709 PECOS PAC ID: 3476860388 Enrollment ID: I20150909002502 |
| Provider Name | Hardeep Kataria |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1043564362 PECOS PAC ID: 8921223454 Enrollment ID: I20151110002655 |
| Provider Name | Morgan E Renner |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1649565920 PECOS PAC ID: 7517270044 Enrollment ID: I20160719000677 |
| Provider Name | Elizabeth Du |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1730393398 PECOS PAC ID: 7012104995 Enrollment ID: I20160919002522 |
| Provider Name | Joel M Solano |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1952380834 PECOS PAC ID: 0042235798 Enrollment ID: I20170131001515 |
| Provider Name | Sanjeev Grewal |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1972573103 PECOS PAC ID: 0840483046 Enrollment ID: I20170223001907 |
| Provider Name | Sharon M Dyer |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1063866887 PECOS PAC ID: 6204124233 Enrollment ID: I20170403002195 |
| Provider Name | Tarek Alasil |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1003072786 PECOS PAC ID: 6406048727 Enrollment ID: I20170523002897 |
| Provider Name | Jeffrey L Stevens |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1114254711 PECOS PAC ID: 1153446950 Enrollment ID: I20170524001705 |
| Mailing Address | Practice Location Address |
|---|---|
| Trilogy Eye Medical Group Inc 100 E. California Blvd, Pasadena, CA 91105-3205 Ph: (888) 884-3805 | Trilogy Eye Medical Group Inc 100 E California Blvd, Pasadena, CA 91105-3205 Ph: (626) 568-8838 |