Provider Demographics
NPI:1861655193
Name:FONG, THOMAS YOUNG II (OD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:YOUNG
Last Name:FONG
Suffix:II
Gender:M
Credentials:OD
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Mailing Address - Street 1:5623 FREEPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95822-3501
Mailing Address - Country:US
Mailing Address - Phone:916-451-4494
Mailing Address - Fax:916-451-4229
Practice Address - Street 1:5623 FREEPORT BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95822-3501
Practice Address - Country:US
Practice Address - Phone:916-451-4494
Practice Address - Fax:916-451-4229
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA13493152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist