Provider Demographics
NPI:1154873040
Name:DAVID WONG, O.D., VISIO OPTOMETRY, INC.
Entity type:Organization
Organization Name:DAVID WONG, O.D., VISIO OPTOMETRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:626-483-8304
Mailing Address - Street 1:24201 VALENCIA BLVD
Mailing Address - Street 2:2302
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1861
Mailing Address - Country:US
Mailing Address - Phone:661-287-9023
Mailing Address - Fax:661-287-3831
Practice Address - Street 1:24201 VALENCIA BLVD
Practice Address - Street 2:2302
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1861
Practice Address - Country:US
Practice Address - Phone:661-287-9023
Practice Address - Fax:661-287-3831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT11979TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty