Organization Active NPI

Khanh Kristine Tong, O.D., Inc

  • Optometrist
  • Westminster, CA
National Provider Identifier
1386802320
Registry record updated May 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11759T Issued in CA
Legal business name
KHANH KRISTINE TONG, O.D., INC
Practice address
9651 Bolsa Ave
Suite a
Westminster, CA 92683-5906
Phone
(714) 839-9915
Fax
(714) 839-9974
NPI assigned
May 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2008

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

Authorized official

Name
Khanh Kristine TongNPI 1033296645
Title
Optometrist/Owner
Phone
(714) 839-9915

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 11759T CA Primary

Addresses

Primary practice location

9651 Bolsa Ave
Suite a
Westminster, CA 92683-5906

Mailing address

9651 Bolsa Ave
Suite a
Westminster, CA 92683-5906
Phone (714) 839-9915

Other identifiers 1

IdentifierTypeStateIssuer
SD0117590MedicaidCA

Other names 1

  • MyOptics Optometry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211216000916 CA Part B Supplier - Clinic/Group Practice 0143611624 Receives reassigned benefits from 2 practitioners
Practice locations: Westminster, CA

National Provider Directory

National Provider Directory

Locations

9651 Bolsa Ave
Ste A
Westminster, CA 92683
Phone (714) 839-9915

9741 Bolsa Ave
Ste 115
Westminster, CA 92683
Phone (714) 839-9915

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211846400000",
    "number": "1386802320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9651 BOLSA AVE",
            "address_2": "SUITE A",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926835906",
            "telephone_number": "714-839-9915",
            "fax_number": "714-839-9974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9651 BOLSA AVE",
            "address_2": "SUITE A",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926835906",
            "telephone_number": "714-839-9915",
            "fax_number": "714-839-9974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHANH KRISTINE TONG, O.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-27",
        "last_updated": "2008-05-27",
        "status": "A",
        "authorized_official_last_name": "TONG",
        "authorized_official_first_name": "KHANH",
        "authorized_official_middle_name": "KRISTINE",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "714-839-9915"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11759T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0117590",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MyOptics Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westminster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.