Individual
AMANDA TANG VONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11100 EUCLID AVE, LAKESIDE BUILDING SUITE 6223, CLEVELAND, OH 44106-1716
(216) 844-3887
(216) 844-1949
Mailing address
17284 SLOVER AVE STE 202, FONTANA, CA 92337-7584
(909) 609-3200
(909) 609-3203
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A141034
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/24/2012
Last updated
12/15/2021
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