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Organization
WILLIAM Y S TOM & WESLEY F TOM PTRS
Active
Organization
WILLIAM Y S TOM & WESLEY F TOM PTRS
Active
Other names
Tom and Tom Optometrists
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WESLEY FONG TOM OD (DOCTOR OF OPTOMETRY)
(213) 680-9393
Entity
Organization
Contact information
Practice address
942 N BROADWAY, SUITE 104, LOS ANGELES, CA 90012-1707
(213) 680-9393
(213) 680-2921
Mailing address
942 N BROADWAY, SUITE 104, LOS ANGELES, CA 90012-1707
(213) 680-9393
(213) 680-2921
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9469T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WOP9469A
MEDICARE LEGACY
CA
Enumeration date
05/05/2007
Last updated
07/16/2012
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