Active NPI
Wesley Fong Tom, O.D.
- Optometrist
- Los Angeles, CA
National Provider Identifier
1134208358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 9469T
- Practice address
- 2825 Crenshaw Blvd
Los Angeles, CA 90016-3603 - Phone
- (323) 373-9633
- NPI assigned
- Nov 6, 2006
- Sex
- Male
- 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 | 9469T | CA | Primary |
Addresses
Primary practice location
2825 Crenshaw Blvd
Los Angeles, CA 90016-3603
Mailing address
2825 Crenshaw Blvd
Los Angeles, CA 90016-3603
Phone (323) 373-9633
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0946900 | Medicaid | CA | |
| WY076 | Other | MEDICARE LEGACY | |
| X15393 | Other | MEDICARE LEGACY | |
| WOP9469A | Other | MEDICARE LEGACY |
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 |
|---|---|---|---|
| 9469T | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| WFT Optometric Group | Optometrist | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Optometrist
- Los Angeles, CA
- NPI 1275143661
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788307200000",
"number": "1134208358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2825 CRENSHAW BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900163603",
"telephone_number": "323-373-9633",
"fax_number": "323-373-9844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2825 CRENSHAW BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900163603",
"telephone_number": "323-373-9633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOM",
"first_name": "WESLEY",
"middle_name": "FONG",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-06",
"last_updated": "2026-09-02",
"certification_date": "2026-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "9469T",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0946900",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE LEGACY",
"identifier": "WY076",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE LEGACY",
"identifier": "X15393",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE LEGACY",
"identifier": "WOP9469A",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.