Provider Demographics
NPI:1346478591
Name:BELLOMY, LINDA LUONG (OD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:LUONG
Last Name:BELLOMY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:LUONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:795 E SECOND STREET
Mailing Address - Street 2:SUITE 2
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-2007
Mailing Address - Country:US
Mailing Address - Phone:909-706-3899
Mailing Address - Fax:909-469-8640
Practice Address - Street 1:795 E SECOND STREET
Practice Address - Street 2:SUITE 2
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-2007
Practice Address - Country:US
Practice Address - Phone:909-706-3899
Practice Address - Fax:909-469-8640
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13719TLG152W00000X, 152WP0200X, 152WV0400X, 152WS0006X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB210934Medicare PIN