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General NPI Number Information
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NPI Number | 1053277848
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Entity Type | Organization
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Legal Business Name | MELISSA S. WONG, OD, INC
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Dates
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Enumeration Date | 12/24/2025
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Last Update Date | 12/24/2025
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Provider Practice Location Address
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Address Line | 38 W SIERRA MADRE BLVD STE K
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City | SIERRA MADRE
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State | CA
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Zip | 91024-2488
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Country | US
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Telephone | 626-272-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 8540 RAVENDALE RD
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City | SAN GABRIEL
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State | CA
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Zip | 91775-1122
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Country | US
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Telephone | 626-272-3600
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. MELISSA S WONG
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Credential | OD
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Telephone | 626-272-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number |
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License Number State |
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