Organization
KING YUE WONG OD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KING YUE WONG OD (DIRECTOR OWNER)
(310) 471-9618
Entity
Organization
Contact information
Practice address
1431 SEVENTH STREET, SUITE #201, SANTA MONICA, CA 90401-2638
(310) 450-9998
(310) 450-8580
Mailing address
316 SOUTH KENTER AVE, LOS ANGELES, CA 90049-4022
(310) 471-9618
(310) 450-8580
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OPT12461TPA
CA
152WL0500X
Low Vision Rehabilitation Optometrist
OPT12461TPA
CA
152WP0200X
Pediatric Optometrist
Primary
OPT12461TPA
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0124610
—
CA
01
—
SD0124611
MEDI CAL
CA
Enumeration date
10/25/2006
Last updated
09/11/2025
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