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NPI Code Detail

MEDICARE: DR. ALFRED VONG O.D.

MEDICARE:  DR. ALFRED  VONG  O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristOPT15360TLGCA

General Provider Information

NPI Number : 1528441086
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALFRED VONG O.D.
Provider Business Mailing Address
First Line : 471 SKYLINE DR
Second Line :
City : DALY CITY
State : CA
Zip : 94015-4562
Country : US
Telephone Number : 650-296-7238
Fax Number :
Provider Business Practice Location Address
First Line : 230 MINOR HALL MC 2020
Second Line :
City : BERKELEY
State : CA
Zip : 94720-2020
Country : US
Telephone Number : 510-642-2020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2015
Last Update Date : 02/11/2022

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