NPIMap

Organization Active NPI

Dr Thomas Y Fong OD Inc

Doing business as Eyewear Designs Optometry

  • Optometrist
  • Auburn, CA
National Provider Identifier
1568688927
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7187 Issued in CA
Legal business name
DR THOMAS Y FONG OD INC
Doing business as
Eyewear Designs Optometry
Practice address
1241 Grass Valley Highway
Auburn, CA 95603-3413
Phone
(530) 888-0303
Fax
(530) 888-0855
NPI assigned
Apr 17, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Thomas Y Fong, ODNPI 1861655193
Title
President
Phone
(530) 888-0303

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
Optometrist 152W00000X 7187 CA Primary

Addresses

Primary practice location

1241 Grass Valley Highway
Auburn, CA 95603-3413

Mailing address

1241 Grass Valley Highway
Auburn, CA 95603-3413
Phone (530) 888-0303

Other identifiers 1

IdentifierTypeStateIssuer
SD0071870MedicaidCA

Other names 1

  • Eyewear Designs Optometry Doing business as

National Provider Directory

National Provider Directory

Locations

1241 Grass Valley Hwy
Auburn, CA 95603
Phone (530) 888-0303

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1568688927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1241 GRASS VALLEY HIGHWAY",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956033413",
            "telephone_number": "530-888-0303",
            "fax_number": "530-888-0855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1241 GRASS VALLEY HIGHWAY",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956033413",
            "telephone_number": "530-888-0303",
            "fax_number": "530-888-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR THOMAS Y FONG OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FONG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-888-0303",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0071870",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eyewear Designs Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Auburn, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.