WEST COAST RETINA - NPI 1053389064 - Ophthalmology in San Francisco, CA

Q: What is the provider's specialty?

The provider's specialty is Ophthalmology with taxonomy code 207WX0107X and a focus in Retina Specialist.

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About West Coast Retina NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WEST COAST RETINA (NPI 1053389064) is a healthcare organization registered as a retina specialist in San Francisco, California and active in the NPI registry since March 2006. The organization holds a CLIA Waiver certificate valid through May 21, 2028, maintains 4 additional practice locations, and lists Benjamin M Higginbotham, Coo, as its authorized official.

NPPES Registry Identity

NPI1053389064

Entity TypeOrganization

Primary Taxonomy207WX0107X

Legal Business NameWEST COAST RETINA MEDICAL GROUP, INC.

Location Address1445 BUSH STSan Francisco, CA 94109-5520

Mailing Address1445 Bush StSan Francisco, CA 94109-5520 · (415) 972-4600 · Fax (415) 975-0999

Phone(415) 972-4600

Fax(415) 975-0999

Organization SubpartNo

Authorized OfficialBenjamin M HigginbothamCoo · (415) 972-4626

Enumeration DateMarch 8, 2006

Last NPPES UpdateFebruary 3, 20202 updates tracked since enumeration

✔ NPI 1053389064 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyOphthalmology · Retina SpecialistAllopathic & Osteopathic Physicians

Taxonomy Code207WX0107X

Definition

An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.

Also ListedOphthalmologyTaxonomy 207W00000X

Also ListedOphthalmology · Uveitis and Ocular Inflammatory DiseaseTaxonomy 207WX0108X

1445 BUSH ST, San Francisco, CA 94109

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Other Names 1

Doing Business AsWest Coast Retina

Secondary Practice Locations 4

Location 1400 30th StOakland, CA 94609-3306 · Phone (510) 268-8277 · Fax (510) 350-8803

Location 2101 S San Mateo Dr Ste 265San Mateo, CA 94401-3819 · Phone (650) 342-7137

Location 31981 N Broadway Ste 265Walnut Creek, CA 94596-3827 · Phone (925) 295-1727 · Fax (925) 954-7029

Location 4100 Tamal Plz Ste 120Corte Madera, CA 94925-1176 · Phone (415) 927-6600 · Fax (415) 891-3329

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2104668

West Coast Retina Medical Group, Inc. · San Francisco, CA

Active · expires May 21, 2028

CLIA Number05D2104668

Laboratory TypePhysician Office

Certificate Effective DateMay 22, 2026

Certificate Expiration DateMay 21, 2028

Laboratory DirectorJames M. Jumper

Laboratory Phone(415) 972-4600

Laboratory LocationWest Coast Retina Medical Group, Inc.1445 Bush St, San Francisco, CA 94109

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.