Testin Tai Jun Kwong, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

34969 Issued in CA

Practice address

305 Broadway
Millbrae, CA 94030-2509

Phone

(650) 697-2475

NPI assigned

Sep 23, 2021

Sex

Male

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 and National Provider Directory roles.

• Elena Wong O.D., Inc.

  • Optometrist
  • Belmont, CA
  • NPI 1386283935
  NPD (past)
• Palo Alto Medical Foundation

  • Non-Pharmacy Dispensing Site
  • Santa Cruz, CA
  • NPI 1114182649
  NPD (past)

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

{
    "created_epoch": "1632355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1316618986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2167 19TH AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941161802",
            "telephone_number": "415-490-7409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 BROADWAY",
            "city": "MILLBRAE",
            "state": "CA",
            "postal_code": "940302509",
            "telephone_number": "650-697-2475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWONG",
        "first_name": "TESTIN",
        "middle_name": "TAI JUN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-23",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Kim
• King Health Center
• Cathy Lynn Klemz
• Wesley Kong
• Kei Kurotani, L.AC, PH.D
• Christopher Lam
• Ka Lau, RD
• Kevin Le, PHARMD
• Ariel Diane Leasure, OTR
• Ashley Lee, PHARM.D

• Optometrist in Millbrae, CA
• Providers in Millbrae, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.