Provider Demographics
NPI:1124021688
Name:ONG, OLIVIA CHOON (MD)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:CHOON
Last Name:ONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HEONG
Other - Middle Name:CHOON
Other - Last Name:ONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14726 RAMONA AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-5730
Mailing Address - Country:US
Mailing Address - Phone:626-305-9100
Mailing Address - Fax:626-305-0152
Practice Address - Street 1:855 W FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:MONROVIA
Practice Address - State:CA
Practice Address - Zip Code:91016-1938
Practice Address - Country:US
Practice Address - Phone:626-358-1080
Practice Address - Fax:626-358-0548
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA66933207WX0009X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A669330Medicaid
CA00A669331OtherBLUE CROSS
CA180044668Medicare PIN
CA00A669331OtherBLUE CROSS
CA00A669330Medicaid