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Individual
TOM KIEN WONG
Active
Individual
TOM KIEN WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11324T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0113240
—
CA
Enumeration date
09/29/2006
Last updated
09/28/2011
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