Individual
DR. GRACE K. WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
80 N LAKE AVE, #102, PASADENA, CA 91101-5626
(626) 356-8088
(626) 356-8078
Mailing address
6043 AGNES AVE, TEMPLE CITY, CA 91780-1708
(626) 451-6803
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
10607T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0106070
—
CA
Enumeration date
01/30/2006
Last updated
05/01/2017
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