Healthcare Provider Details

I. General information

NPI: 1972439677
Provider Name (Legal Business Name): LUONG OPTOMETRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 STORY RD STE 1079
SAN JOSE CA
95122-2670
US

IV. Provider business mailing address

1150 WILLOW GLEN WAY
SAN JOSE CA
95125-3349
US

V. Phone/Fax

Practice location:
  • Phone: 408-288-5037
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MONICA LUONG
Title or Position: OPTOMETRIST
Credential: OD
Phone: 408-886-4803