MEDICARE: DR. DORIS WONG 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
1	152WC0802X	Corneal and Contact Management Optometrist	618	NV
2	152W00000X	Optometrist	OPT 8138	CA
3	152W00000X	Optometrist	618	NV

General Provider Information

NPI Number	:	1659355048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DORIS WONG O.D.

Provider Business Mailing Address
First Line	:	2090 E FLAMINGO RD STE 101
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5116
Country	:	US
Telephone Number	:	702-734-9600
Fax Number	:	725-999-3781

Provider Business Practice Location Address
First Line	:	2090 E FLAMINGO RD STE 101
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5116
Country	:	US
Telephone Number	:	702-734-9600
Fax Number	:	725-999-3781

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	07/15/2024

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Directions to “ DR. DORIS WONG O.D.” Practice Location

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