Active NPI
Avon Wai Kwong, OD
- Optometrist
- San Francisco, CA
National Provider Identifier
1427029123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 9376TPL
- Practice address
- 611 Broadway
San Francisco, CA 94133-4405 - Phone
- (415) 982-0388
- Fax
- (415) 217-7010
- NPI assigned
- Jan 30, 2006
- Last updated
- Aug 6, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 9376TPL | CA | Primary |
Addresses
Primary practice location
611 Broadway
San Francisco, CA 94133-4405
Mailing address
611 Broadway
San Francisco, CA 94133-4405
Phone (415) 982-0388
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0093760 | Medicaid | CA |
Other names 1
- Dr. Avon Wai
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9376TPL | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Avon Wai Kwong, O.D., Inc. | Optometrist | Current | Accepting new patients |
| Avon Wai Kwong | Optometrist | Past | Accepting new patients |
Locations
611 Broadway
San Francisco, CA 94133
Phone (415) 982-0388
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281052800000",
"number": "1427029123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 BROADWAY",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941334405",
"telephone_number": "415-982-0388",
"fax_number": "415-217-7010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 BROADWAY",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941334405",
"telephone_number": "415-982-0388",
"fax_number": "415-217-7010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWONG",
"first_name": "AVON",
"middle_name": "WAI",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-01-30",
"last_updated": "2010-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "9376TPL",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0093760",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "AVON",
"last_name": "WAI",
"prefix": "DR.",
"credential": "OD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.