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General NPI Number Information
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NPI Number | 1265816334
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Entity Type | Individual
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Provider Name | DANNY WONG O.D.
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Gender | Male
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Dates
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Enumeration Date | 07/17/2015
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Last Update Date | 05/13/2016
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Provider Practice Location Address
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Address Line | 457 LOS CERRITOS CENTER
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City | CERRITOS
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State | CA
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Zip | 90703
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Country | US
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Telephone | 562-809-8826
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Fax | 562-809-4113
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Provider Business Mailing Address
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Address Line | 457 LOS CERRITOS CENTER
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City | CERRITOS
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State | CA
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Zip | 90703-6564
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Country | US
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Telephone | 562-650-0116
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 15338
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License Number State | CA
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