Provider Demographics
NPI:1154425304
Name:TONG, JUDY WAI HAN
Entity type:Individual
Prefix:DR
First Name:JUDY
Middle Name:WAI HAN
Last Name:TONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5460 E LA PALMA AVE
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-2023
Mailing Address - Country:US
Mailing Address - Phone:714-463-7500
Mailing Address - Fax:714-992-7850
Practice Address - Street 1:2575 YORBA LINDA BLVD
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-1699
Practice Address - Country:US
Practice Address - Phone:714-449-7429
Practice Address - Fax:714-992-7871
Is Sole Proprietor?:No
Enumeration Date:2006-09-09
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9862TPL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWOP9862AMedicare ID - Type Unspecified
U96146Medicare UPIN