Active NPI
Tina Huey Fong, O.D.
- Optometrist
- Fair Oaks, CA
National Provider Identifier
1043347859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 7493
- Practice address
- 12417 Fair Oaks Blvd
Suite 500
Fair Oaks, CA 95628-2501 - Phone
- (916) 722-4280
- Fax
- (916) 722-0148
- NPI assigned
- Feb 28, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 7493 | CA | Primary |
Addresses
Primary practice location
12417 Fair Oaks Blvd
Suite 500
Fair Oaks, CA 95628-2501
Mailing address
12417 Fair Oaks Blvd
Suite 500
Fair Oaks, CA 95628-2501
Phone (916) 722-4280
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 207231 | Other | CA | COLE & PEARL VISION ID # |
| 211137 | Other | CA | EYEMED ID # |
| GR0052200 | Medicaid | CA | |
| 13565 | Other | CA | MEDICAL EYE SERVICES ID # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7493 | CA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1043347859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12417 FAIR OAKS BLVD",
"address_2": "SUITE 500",
"city": "FAIR OAKS",
"state": "CA",
"postal_code": "956282501",
"telephone_number": "916-722-4280",
"fax_number": "916-722-0148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12417 FAIR OAKS BLVD",
"address_2": "SUITE 500",
"city": "FAIR OAKS",
"state": "CA",
"postal_code": "956282501",
"telephone_number": "916-722-4280",
"fax_number": "916-722-0148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONG",
"first_name": "TINA",
"middle_name": "HUEY",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-28",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "7493",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COLE & PEARL VISION ID #",
"identifier": "207231",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EYEMED ID #",
"identifier": "211137",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0052200",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL EYE SERVICES ID #",
"identifier": "13565",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fair Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.