Healthcare Provider Details

I. General information

NPI: 1831016864
Provider Name (Legal Business Name): MODERN SIGHT EYECARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24675 N 23RD AVE, PHOENIX
PHOENIX AZ
85085
US

IV. Provider business mailing address

6501 W MOLLY LN
PHOENIX AZ
85083-6516
US

V. Phone/Fax

Practice location:
  • Phone: 925-998-3444
  • Fax:
Mailing address:
  • Phone: 925-998-3444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER WONG
Title or Position: MANAGING MEMBER
Credential: OD
Phone: 925-998-3444