Michael Wong OD LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD133 Issued in HI

Legal business name

MICHAEL WONG OD LLC

Practice address

1401 S Beretania St
Suite 340
Honolulu, HI 96814-1870

Phone

(808) 735-7633

Fax

(808) 735-2400

NPI assigned

Apr 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael K.H. Wong, O.D.

Title

Owner

Phone

(808) 735-7633

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326412800000",
    "number": "1245457118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S BERETANIA ST",
            "address_2": "SUITE 340",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141870",
            "telephone_number": "808-735-7633",
            "fax_number": "808-735-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S BERETANIA ST",
            "address_2": "SUITE 340",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141870",
            "telephone_number": "808-735-7633",
            "fax_number": "808-735-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL WONG OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2012-01-13",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "K.H.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-735-7633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "HI",
            "license": "OD133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05158901",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Optometrist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; 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.