Provider Demographics
NPI:1093093080
Name:DONG, NOORIE C (OD)
Entity type:Individual
Prefix:
First Name:NOORIE
Middle Name:C
Last Name:DONG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2817 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-2901
Mailing Address - Country:US
Mailing Address - Phone:408-984-2020
Mailing Address - Fax:408-984-2016
Practice Address - Street 1:2817 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-2901
Practice Address - Country:US
Practice Address - Phone:408-984-2020
Practice Address - Fax:408-984-2016
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14164 TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist