Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Retinal Consultants of Southern California Medical Group, Inc

Organization Specialist · NPI 1700807815

Retinal Consultants of Southern California Medical Group, Inc is a Specialist in Westlake Village, California. Licensed in California. Registered with an NPI since 2006.

Licensed in
CA
In the registry since
2006
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1220 La Venta Dr Ste 211
Westlake Village, CA 91361-3703
Phone: (805) 379-0200
Fax: (805) 496-5204
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence G33939 (CA)

Record details

NPI number1700807815
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kenneth Diddie — President · (805) 379-0200
NPI enumeratedJuly 22, 2006
Last updated in NPPESSeptember 26, 2023
Certification dateSeptember 26, 2023
Mailing address1220 La Venta Dr, Suite 211, Westlake Village, CA 91361-3703

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