Organization
ALETA B. GONG-TANG, OD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD PRATT (OFFICE MANAGER)
(602) 547-3255
Entity
Organization
Contact information
Practice address
16020 N 35TH AVE STE 2, PHOENIX, AZ 85053-3823
(602) 547-3255
(602) 375-9580
Mailing address
16020 N 35TH AVE STE 2, PHOENIX, AZ 85053-3823
(602) 547-3255
(602) 375-9580
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
152WS0006X
Sports Vision Optometrist
—
—
152WV0400X
Vision Therapy Optometrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z103102
MEDICARE Z
AZ
Enumeration date
03/24/2008
Last updated
03/24/2008
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