Organization Active NPI

Justin Wong OD an Optometric Corporation

  • Optometrist
  • Irvine, CA
National Provider Identifier
1598323602
Registry record updated Jun 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
JUSTIN WONG OD AN OPTOMETRIC CORPORATION
Practice address
250 E Yale Loop Ste G
Irvine, CA 92604-4697
Phone
(949) 333-7504
Fax
(949) 333-7503
NPI assigned
Jun 4, 2019
Last updated
Jun 4, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2019

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

Authorized official

Name
Dr. Justin Wyman Wong, OD
Title
Optometrist
Phone
(714) 928-3612

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

250 E Yale Loop Ste G
Irvine, CA 92604-4697

Mailing address

474 Monroe
Irvine, CA 92620-3656
Phone (714) 928-3612

National Provider Directory

National Provider Directory

Locations

250 E Yale Loop
Ste G
Irvine, CA 92604
Phone (949) 333-7504

Practitioners & affiliated clinicians

Practitioners 2

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": "1559606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559606400000",
    "number": "1598323602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "474 MONROE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926203656",
            "telephone_number": "714-928-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E YALE LOOP STE G",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044697",
            "telephone_number": "949-333-7504",
            "fax_number": "949-333-7503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTIN WONG OD AN OPTOMETRIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-04",
        "last_updated": "2019-06-04",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "WYMAN",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "714-928-3612",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; 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.