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General NPI Number Information
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NPI Number | 1518000231
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Entity Type | Individual
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Provider Name | JENNY ONG O.D.
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Gender | Female
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 07/05/2013
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Provider Practice Location Address
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Address Line | 3873 PORTOLA PKWY
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City | IRVINE
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State | CA
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Zip | 92602-0828
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Country | US
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Telephone | 714-730-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 2240 NELSON AVE
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City | TUSTIN
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State | CA
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Zip | 92782-1068
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Country | US
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Telephone | 714-501-5300
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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 | 10346T
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License Number State | CA
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