Organization
ANDREW G CHONG, O.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW G CHONG O.D. (OWNER)
(626) 918-1407
Entity
Organization
Contact information
Practice address
1641 N HACIENDA BLVD, LA PUENTE, CA 91744-1137
(626) 918-1407
(626) 918-2069
Mailing address
1641 N HACIENDA BLVD, LA PUENTE, CA 91744-1137
(626) 918-1407
(626) 918-2069
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
CA7758
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0017050
—
CA
Enumeration date
12/19/2006
Last updated
08/21/2015
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