Individual
DR. CLINTON KING WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
12810 HEACOCK ST, SUITE B104, MORENO VALLEY, CA 92553-2854
(951) 924-2020
(951) 924-7136
Mailing address
12810 HEACOCK ST, SUITE B104, MORENO VALLEY, CA 92553-2854
(951) 924-2020
(951) 924-7136
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
7725T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0077250
—
CA
Enumeration date
02/23/2007
Last updated
07/08/2007
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