Andrew G Chong, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

CA7758 Issued in CA

Practice address

1641 N Hacienda Blvd
La Puente, CA 91744-1137

Phone

(626) 918-1407

Fax

(626) 918-2069

NPI assigned

Dec 19, 2006

Sex

Male

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Chino Optometry Center

  • Optometrist
  • Chino, CA
  • NPI 1639211360

  CA, Optometrist

  Medicare reassignment NPD
• Andrew G Chong, O.D.

  • Optometrist
  • La Puente, CA
  • NPI 1669535613
  NPD (past) Authorized official

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 9, 2007.

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1073676029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1641 N HACIENDA BLVD",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917441137",
            "telephone_number": "626-918-1407",
            "fax_number": "626-918-2069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 N HACIENDA BLVD",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917441137",
            "telephone_number": "626-918-1407",
            "fax_number": "626-918-2069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHONG",
        "first_name": "ANDREW",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "CA7758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0077580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peter Chen
• Shu Chen Chen
• Tiffany CHI
• Joshua Chia
• Dooyong Choi
• Thomas Wan Chong, MD
• David Chou, D.D.S.
• Lin Liu Chou, L.AC
• Citrus Valley Family Medical Clinic, Inc.
• Clinica Medica del Sol Group Inc

• All providers in La Puente, CA
• Optometrist in California

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.