Provider Demographics
NPI:1508274416
Name:WONG, VICTOR J (OD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:J
Last Name:WONG
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:395 CIVIC DR
Mailing Address - Street 2:SUITE G
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-1979
Mailing Address - Country:US
Mailing Address - Phone:925-676-8365
Mailing Address - Fax:925-676-3382
Practice Address - Street 1:4501 SAND CREEK RD
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-8687
Practice Address - Country:US
Practice Address - Phone:925-813-3280
Practice Address - Fax:925-813-3341
Is Sole Proprietor?:No
Enumeration Date:2014-07-24
Last Update Date:2022-01-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAOPT 15042 TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist