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General NPI Number Information
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NPI Number | 1871677344
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Entity Type | Organization
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Legal Business Name | JAMES H. WONG, OD, PROFESSIONAL OPTOMETRIC CORPORATION
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 03/19/2015
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Provider Practice Location Address
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Address Line | 1826 BUCHANAN STREET SUITE A
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City | SAN FRANCISCO
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State | CA
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Zip | 94115-3211
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Country | US
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Telephone | 415-931-1903
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Fax | 415-931-1904
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Provider Business Mailing Address
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Address Line | 1826 BUCHANAN STREET SUITE A
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City | SAN FRANCISCO
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State | CA
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Zip | 94115-3211
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Country | US
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Telephone | 415-931-1903
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Fax | 415-931-1904
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAMES H WONG
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Credential | O.D.
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Telephone | 415-931-1903
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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 | 7604TLG
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License Number State | CA
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