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SAN GABRIEL RETINA PC
NPI 1891264818
Ophthalmology - Retina Specialist in San Gabriel, CA

Active since November 19, 2018CLIA 05D2335084 · Waiver
416 W LAS TUNAS DR STE 105, SAN GABRIEL, CA 91776(626) 262-2082(626) 317-8128 Get Directions Write a Review

NPPES record last updated: November 5, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 5, 2024, Nov 10, 2022, Jan 21, 2019 and 2 more (5 updates tracked since 2018).

About San Gabriel Retina Pc NPPES

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

SAN GABRIEL RETINA PC (NPI 1891264818) is a healthcare organization registered as a retina specialist in San Gabriel, California and active in the NPI registry since November 2018. The organization holds a CLIA Waiver certificate valid through December 4, 2027 and lists Yi Jiang, President, as its authorized official.

NPPES Registry Identity

NPI1891264818
Entity TypeOrganization
Primary Taxonomy207WX0107X
Legal Business NameSAN GABRIEL RETINA PC
Location Address416 W LAS TUNAS DR STE 105San Gabriel, CA 91776-1236
Mailing Address416 W Las Tunas Dr Ste 105San Gabriel, CA 91776-1236 · (626) 262-2082
Phone(626) 262-2082
Fax(626) 317-8128
Organization SubpartNo
Authorized OfficialYi JiangPresident · (626) 262-2082
Enumeration DateNovember 19, 2018
Last NPPES UpdateNovember 5, 20245 updates tracked since enumeration
NPPES CertifiedNovember 5, 2024
✔ NPI 1891264818 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmology · Retina SpecialistAllopathic & Osteopathic Physicians
Taxonomy Code207WX0107X
Definition

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

416 W LAS TUNAS DR STE 105, San Gabriel, CA 91776
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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 05D2335084

San Gabriel Retina · City Of Industry, CA
Active · expires Dec 4, 2027
CLIA Number05D2335084
Laboratory TypePhysician Office
Certificate Effective DateDecember 5, 2025
Certificate Expiration DateDecember 4, 2027
Laboratory DirectorJang Yi
Laboratory Phone(626) 262-2082
Laboratory LocationSan Gabriel Retina18605 Gale Ave Ste 120, City Of Industry, CA 91748
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

YI JIANG MD
Ophthalmology (Retina Specialist)
416 W LAS TUNAS DR STE 105
SAN GABRIEL, CA 91776
Los Angeles County (626) 262-2082
GEORGE ZHANG MD
Ophthalmology
416 W LAS TUNAS DR STE 105
SAN GABRIEL, CA 91776
Los Angeles County (626) 262-2082

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is San Gabriel Retina PC's NPI number?

The NPI number for San Gabriel Retina PC is 1891264818. It was assigned to this organization in the NPPES registry on November 19, 2018.

Where is San Gabriel Retina PC located?

San Gabriel Retina PC is located at 416 W Las Tunas Dr Ste 105, San Gabriel, CA 91776. The listed phone number is (626) 262-2082.

What is San Gabriel Retina PC's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Retina Specialist, with taxonomy code 207WX0107X.

Does San Gabriel Retina PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2335084) is associated with this NPI, valid through December 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for San Gabriel Retina PC was last updated on November 5, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.