| Organization Name: | RETINAL DIAGNOSTIC CENTER A MEDICAL CORPORATION |
| NPI Number: | 1518030568 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TIM KELLEY (OFFICE MANAGER) |
| Mailing Address: | 3395 S. Bascom Ave. Suite 140 Campbell |
| State: | CA US |
| Postal Code: | 95008 |
| Phone Number: | 4085590666 |
| Fax Number: | 4089635920 |
| NPI Enumeration Date: | 11/16/2006 |
| NPI Last Update Date: | 03/11/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | G60723 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |