Provider Demographics
NPI:1275607384
Name:TONG, SENOCH P (OD)
Entity Type:Individual
Prefix:DR
First Name:SENOCH
Middle Name:P
Last Name:TONG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:899 WASHINGTON ST
Mailing Address - Street 2:SUITE 006
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-1245
Mailing Address - Country:US
Mailing Address - Phone:415-781-4524
Mailing Address - Fax:415-392-5492
Practice Address - Street 1:899 WASHINGTON ST
Practice Address - Street 2:SUITE 006
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-1245
Practice Address - Country:US
Practice Address - Phone:415-781-4524
Practice Address - Fax:415-392-5492
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2010-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASD0065740152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0065741Medicaid
CASD0065741Medicaid
CAEB527AMedicare PIN