Individual
THOMAS WAI-TIM WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3 COLUMBUS CIR, NEW YORK, NY 10019-8760
(212) 247-5848
Mailing address
4482 VILLAGE DR APT M, CHINO HILLS, CA 91709-3758
(909) 469-8773
(909) 469-5228
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
008704
NY
152W00000X
Optometrist
15205TLG
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB242473
MEDICARE PTAN SO CAL
CA
Enumeration date
08/07/2014
Last updated
12/06/2021
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