Organization Active NPI

Avon Wai Kwong, O.D., Inc.

  • Optometrist
  • San Francisco, CA
National Provider Identifier
1558600064
Registry record updated Feb 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9376TPL Issued in CA
Legal business name
AVON WAI KWONG, O.D., INC.
Doing business as
Eye Studio Optometry
Practice address
611 Broadway
San Francisco, CA 94133-4405
Phone
(415) 982-0388
Fax
(415) 217-7010
NPI assigned
Feb 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2013

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

Authorized official

Name
Dr. Avon Wai Kwong, O.D.NPI 1427029123
Title
President
Phone
(415) 982-0388

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 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 names 1

  • Eye Studio Optometry Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130402000260 CA Part B Supplier - Clinic/Group Practice 4082859640 Receives reassigned benefits from 2 practitioners
Practice locations: San Francisco, CA

National Provider Directory

National Provider Directory

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": "1359936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359936000000",
    "number": "1558600064",
    "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": {
        "organization_name": "AVON WAI KWONG, O.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-04",
        "last_updated": "2013-02-04",
        "status": "A",
        "authorized_official_last_name": "KWONG",
        "authorized_official_first_name": "AVON",
        "authorized_official_middle_name": "WAI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-982-0388",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9376TPL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Studio Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 4, 2013; 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.