Organization Active NPI

Stanley Huey, O.D. & Tina H. Fong, O.D.

  • Optometrist
  • Fair Oaks, CA
National Provider Identifier
1669557096
Registry record updated Dec 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
STANLEY HUEY, O.D. & TINA H. FONG, O.D.
Practice address
12417 Fair Oaks Blvd
Suite 500
Fair Oaks, CA 95628-2501
Phone
(916) 722-4280
Fax
(916) 722-0148
NPI assigned
Oct 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2009

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

Authorized official

Name
Dr. Tina Huey Fong, O.D.
Title
Optometrist/General Partner
Phone
(916) 722-4280

Specialties & licenses 1

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

Addresses

Primary practice location

12417 Fair Oaks Blvd
Suite 500
Fair Oaks, CA 95628-2501

Mailing address

12417 Fair Oaks Blvd.
Suite 500
Fair Oaks, CA 95628-2558
Phone (916) 722-4280

Other identifiers 1

IdentifierTypeStateIssuer
GR0052200MedicaidCA

National Provider Directory

National Provider Directory

Locations

12417 Fair Oaks Blvd
Ste 5
Fair Oaks, CA 95628
Phone (916) 722-4280

12417 Fair Oaks Blvd
Ste 500
Fair Oaks, CA 95628
Phone (916) 722-4280

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259712000000",
    "number": "1669557096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12417 FAIR OAKS BLVD.",
            "address_2": "SUITE 500",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956282558",
            "telephone_number": "916-722-4280",
            "fax_number": "916-722-0148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12417 FAIR OAKS BLVD",
            "address_2": "SUITE 500",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956282501",
            "telephone_number": "916-722-4280",
            "fax_number": "916-722-0148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANLEY HUEY, O.D. & TINA H. FONG, O.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2009-12-02",
        "status": "A",
        "authorized_official_last_name": "FONG",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "HUEY",
        "authorized_official_title_or_position": "OPTOMETRIST/GENERAL PARTNER",
        "authorized_official_telephone_number": "916-722-4280",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0052200",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2009; 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.