Provider Demographics
NPI:1427859743
Name:IRIS KWONG AN OPTOMETRIC CORPORATION
Entity type:Organization
Organization Name:IRIS KWONG AN OPTOMETRIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:KWONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-881-3633
Mailing Address - Street 1:2406 CLOVER ST
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-5320
Mailing Address - Country:US
Mailing Address - Phone:510-881-3633
Mailing Address - Fax:
Practice Address - Street 1:600 SHOWERS DR STE 700
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-1434
Practice Address - Country:US
Practice Address - Phone:650-770-7677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-22
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty