Provider Demographics
NPI:1710076740
Name:WONG, JAMES THENH (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:THENH
Last Name:WONG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:9333 ROSECRANS AVE
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-2141
Mailing Address - Country:US
Mailing Address - Phone:562-461-3340
Mailing Address - Fax:562-461-3084
Practice Address - Street 1:9333 ROSECRANS AVE
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-2141
Practice Address - Country:US
Practice Address - Phone:562-461-3340
Practice Address - Fax:562-461-3084
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA12017TPA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU78810Medicare UPIN