Jennifer W Gong, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

13028 Issued in CA

Practice address

555 Shops at Mission Viejo
Ste 30 Shops at Mission Viejo
Mission Viejo, CA 92691

Phone

(949) 364-4010

Fax

(949) 364-4001

NPI assigned

Jan 17, 2007

Last updated

Sep 10, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Luxottica of America Inc.

  dba Lenscrafters #611

  • Eyewear Supplier
  • Riverside, CA
  • NPI 1366598120
  NPD (past)
• Luxottica of America Inc

  dba Lenscrafters #E895

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1245382738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5345 SUNRISE BLVD",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956283546",
            "telephone_number": "949-364-4010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 SHOPS AT MISSION VIEJO",
            "address_2": "STE 30 SHOPS AT MISSION VIEJO",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "92691",
            "telephone_number": "949-364-4010",
            "fax_number": "949-364-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONG",
        "first_name": "JENNIFER",
        "middle_name": "W",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Golden Coast Dermatology, Skin Cancer and Vein Center PC
• Golden Years Inc.
• Lindsay Joy Golden, LMFT
• Bahar Golshahi, DPM
• Nancy Gomez
• Geoffrey Gonick, MD
• Claudia Judith Gonzalez de Griese, B.S., M.S
• Nancy Yareth Gonzalez-McKenzie, LCSW
• Iris Gonzalez-Thrash, LCSW
• David Regan Gonzalez, MD

• Optometrist in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.