Organization
DR. CAROLYN WONG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN M WONG O.D. (OWNER/OPTOMETRIST)
(310) 473-5464
Entity
Organization
Contact information
Practice address
11540 SANTA MONICA BLVD, SUITE 202, LOS ANGELES, CA 90025-7905
(310) 473-5464
Mailing address
11540 SANTA MONICA BLVD, SUITE 202, LOS ANGELES, CA 90025-7905
(310) 473-5464
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
7450T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GSD001670
—
CA
Enumeration date
09/25/2008
Last updated
07/31/2025
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