Provider Demographics
NPI:1497519813
Name:FONG AND WONG OPTOMETRY, INC.
Entity Type:Organization
Organization Name:FONG AND WONG OPTOMETRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:FONG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:415-531-4603
Mailing Address - Street 1:1372 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-2309
Mailing Address - Country:US
Mailing Address - Phone:415-664-3600
Mailing Address - Fax:415-664-3607
Practice Address - Street 1:1372 9TH AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-2309
Practice Address - Country:US
Practice Address - Phone:415-664-3600
Practice Address - Fax:415-664-3607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty