King Yue Wong, OD

Primary specialty

Pediatric OptometristTaxonomy code 152WP0200X

License

OPT12461TPA Issued in CA

Practice address

1431 7TH St
Suite # 201
Santa Monica, CA 90401-2637

Phone

(310) 395-2106

Fax

(310) 450-8580

NPI assigned

Feb 1, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• King Yue Wong OD Inc

  • Pediatric Optometrist
  • Santa Monica, CA
  • NPI 1871678557
  NPD (past) Authorized official
• Christina Choi Cert Acup Corp

  • Acupuncturist
  • Santa Monica, CA
  • NPI 1689737702
  NPD (past)

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

{
    "created_epoch": "1264982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264982400000",
    "number": "1336471440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 S KENTER AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900494022",
            "telephone_number": "310-471-9618",
            "fax_number": "310-450-8580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 7TH ST",
            "address_2": "SUITE # 201",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904012637",
            "telephone_number": "310-395-2106",
            "fax_number": "310-450-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "KING",
        "middle_name": "YUE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-01",
        "last_updated": "2010-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT12461TPA",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "CA",
            "license": "OPT12461TPA",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "CA",
            "license": "OPT12461TPA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID (2ND OFFICE)",
            "identifier": "SD0124611",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI # (ORGANIZATION & GROUP)",
            "identifier": "1871678557",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0124610",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia Wong, PSY.D.
• Genevieve Wong, WHNP-BC
• Harry P Wong, PHARM. D
• Jason Wong, DPT
• Kenneth Ken-Yip Wong, DDS
• Matthew Wong, P.T.
• Michael Dennis Wong, D.D.S.
• Richard Wong
• Steven Gene Wei Wong, MD
• Timothy Kenji Wong, PH.D.

• Pediatric Optometrist in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Pediatric Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2010; 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.