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Individual
DR. WESLEY FONG TOM
Active
Individual
DR. WESLEY FONG TOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9469T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0946900
—
CA
01
—
WOP9469A
MEDICARE LEGACY
—
01
—
WY076
MEDICARE LEGACY
—
01
—
X15393
MEDICARE LEGACY
—
Enumeration date
11/06/2006
Last updated
09/02/2026
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