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General NPI Number Information
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NPI Number | 1831016864
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Entity Type | Organization
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Legal Business Name | MODERN SIGHT EYECARE PLLC
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Dates
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Enumeration Date | 07/01/2026
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Last Update Date | 07/01/2026
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Provider Practice Location Address
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Address Line | 24675 N 23RD AVE, PHOENIX
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City | PHOENIX
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State | AZ
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Zip | 85085
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Country | US
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Telephone | 925-998-3444
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Fax |
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Provider Business Mailing Address
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Address Line | 6501 W MOLLY LN
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City | PHOENIX
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State | AZ
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Zip | 85083-6516
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Country | US
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Telephone | 925-998-3444
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | CHRISTOPHER WONG
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Credential | OD
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Telephone | 925-998-3444
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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 |
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License Number State |
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