Active NPI
Tiffany Amanda Luong, OD
- Optometrist
- San Gabriel, CA
National Provider Identifier
1790494045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT35357-TLG
- Practice address
- 1309 Walnut St
San Gabriel, CA 91776-3309 - Phone
- (626) 664-0303
- NPI assigned
- Nov 15, 2022
- Sex
- Female
- Sole proprietor
- No
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 | OPT35357-TLG | CA | Primary |
Addresses
Primary practice location
1309 Walnut St
San Gabriel, CA 91776-3309
Mailing address
1309 Walnut St
San Gabriel, CA 91776-3309
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT35357-TLG | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668470400000",
"number": "1790494045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1309 WALNUT ST",
"city": "SAN GABRIEL",
"state": "CA",
"postal_code": "917763309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1309 WALNUT ST",
"city": "SAN GABRIEL",
"state": "CA",
"postal_code": "917763309",
"telephone_number": "626-664-0303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUONG",
"first_name": "TIFFANY",
"middle_name": "AMANDA",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-15",
"last_updated": "2022-11-15",
"certification_date": "2022-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "OPT35357-TLG",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Gabriel, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.