Individual provider Active NPI

David Wong, O.D.

  • Optometrist
  • Buena Park, CA
National Provider Identifier
1255535159
Registry record updated Nov 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13211 Issued in CA
Practice address
8450 La Palma Ave
Buena Park, CA 90620-3210
Phone
(714) 527-9236
Fax
(714) 527-5873
NPI assigned
Jun 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13211 CA Primary

Addresses

Primary practice location

8450 La Palma Ave
Buena Park, CA 90620-3210

Mailing address

8450 La Palma Ave
Buena Park, CA 90620-3210
Phone (626) 222-1243

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070706000581 CA Practitioner - Optometry 4284734112 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8450 La Palma Ave
Buena Park, CA 90620-3210
Phone (714) 527-9236

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eye RX, an Optometric Group Optometrist CurrentSince Nov 1, 2011 Accepting new patients
Luxottica of America Inc. Past Accepting new patients

Locations

8450 La Palma Ave
Buena Park, CA 90620
Phone (714) 484-3555

1540 W Foothill Blvd
Upland, CA 91786
Phone (909) 920-0942

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384819200000",
    "number": "1255535159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8450 LA PALMA AVE",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906203210",
            "telephone_number": "626-222-1243",
            "fax_number": "714-527-5873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8450 LA PALMA AVE",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906203210",
            "telephone_number": "714-527-9236",
            "fax_number": "714-527-5873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "DAVID",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2013-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buena Park, CA

Sources for this page

Verify at the official NPI Registry.