DR. CAROLYN MARIE WONG (NPI# 1306971429) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306971429 |
| Entity Type | Individual |
| Full Name | DR. CAROLYN MARIE WONG |
| Credential | O.D. |
| Practice Address |
11540 Santa Monica Blvd Suite 202 Los Angeles CA 90025-7905 |
| Practice Telephone | 3104735464 |
| Practice Fax Number | 3104732536 |
| Mailing Telephone | 3104735464 |
| Mailing Fax Number | 3104732536 |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2020-02-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | 7450T | CA | Eye and Vision Services Providers |
| Y | 152W00000X | Optometrist | OP7450 | CA | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | SD0074500 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023432549 | Carolyn Wong | Nurse Practitioner | 4064 Sidlehill Dr, Olive Branch, MS 38654-6146 | 2014-02-05 |
| 1316203235 | Carolyn Hayes Wong | Emergency Medicine | 622 W 168th St Ste 260, New York, NY 10032-3720 | 2012-04-04 |
| 1952937880 | Carolyn Wong | Student in an Organized Health Care Education/Training Program | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2020-03-23 |
| 1063998144 | Carolyn Lee Wong | Marriage & Family Therapist | 1447 W Beverly Blvd, Montebello, CA 90640-4154 | 2018-07-12 |
| 1669621330 | Carolyn K Wong | Physical Therapist | 110 Haverhill Rd, Suite 401, Amesbury, MA 01913-2123 | 2008-09-17 |
| 1629265095 | Carolyn Wong | Podiatrist | 3616 E 1st St, Los Angeles, CA 90063-2326 | 2007-10-01 |
| 1033105671 | Carolyn Marie Wong | Pharmacist | 400 Ne Mother Joseph Pl, Vancouver, WA 98664-3200 | 2005-09-20 |
| Street Address |
11540 SANTA MONICA BLVD SUITE 202 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90025-7905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063948958 | Kimia Wellness | Clinic/Center | 11540 Santa Monica Blvd, Suite 203, Los Angeles, CA 90025-7905 | 2017-05-11 |
| 1053847939 | Roy Kimia | Acupuncturist | 11540 Santa Monica Blvd, Suite 203, Los Angeles, CA 90025-7905 | 2017-05-11 |
| 1699171298 | Sarah Chung | Optometrist | 11540 Santa Monica Blvd, Los Angeles, CA 90025-7905 | 2014-11-08 |
| 1669898003 | Sara Dadvand | Speech-Language Pathologist | 11540 Santa Monica Blvd, #203, Los Angeles, CA 90025-7905 | 2014-03-10 |
| 1811277569 | Mai T Dinh | Optometrist | 11540 Santa Monica Blvd, Suite 202, Los Angeles, CA 90025-7905 | 2011-08-25 |
| 1710137708 | Dr. Carolyn Wong Optometry | Optometrist | 11540 Santa Monica Blvd, Suite 202, Los Angeles, CA 90025-7905 | 2008-09-25 |
| 1821296716 | Hanh Nguyen-miller | Acupuncturist | 11540 Santa Monica Blvd, Suite 204, Los Angeles, CA 90025-7905 | 2007-07-03 |
| 1093919615 | Pacific West Coast Health Medical Therapy Center Inc. | Family Medicine | 11540 Santa Monica Blvd, 201, Los Angeles, CA 90025-7905 | 2007-06-14 |
| 1699891861 | Dadvand Chiropractic Inc. | Chiropractor | 11540 Santa Monica Blvd, 203, Los Angeles, CA 90025-7905 | 2007-03-21 |
| 1861557282 | Farbod Dadvand | Chiropractor | 11540 Santa Monica Blvd, #203, Los Angeles, CA 90025-7905 | 2006-12-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962324 | Marjan-marcia Khalitchi-alavi | Psychologist | 12400 Wilshire Blvd #230, Los Angeles, CA 90025 | 2020-11-06 |
| 1245852599 | Maureen Bridget Mcglynn | Marriage & Family Therapist | 1531 Purdue Avenue, Los Angeles, CA 90025 | 2020-05-09 |
| 1578118857 | Gregory J Bogie | Physical Therapist | 10351 Santa Monica Blvd. Suite 101, Los Angeles, CA 90025 | 2019-08-05 |
| 1518527712 | David Allen Goldstein | Marriage & Family Therapist | 12301 Wilshire Blvd., Suite 515, Los Angeles, CA 90025 | 2019-06-19 |
| 1386104875 | Kevin Meir Youssefzadeh | Student in an Organized Health Care Education/Training Program | 304 Dowlen Dr, Los Angeles, CA 90025 | 2019-03-21 |
| 1336609189 | Psychotherapy Center for Healing and Personal Growth | Psychologist | 2001 S. Barington Ave Suite 222, Los Angeles, CA 90025 | 2019-03-20 |
| 1477028819 | Flora Ma | Nurse Practitioner | 1726 Purdue Ave, Apt 2, Los Angeles, CA 90025 | 2018-10-12 |
| 1457834285 | Yeesul Yoo | Chiropractor | 2001 S. Barrington Ave Suite 101, Los Angeles, CA 90025 | 2018-09-07 |
| 1902387160 | Angelica Carmen Regalado | Behavior Technician | 7400 Pacific Blvd. Suite A & B, Walnut Park, CA 90025 | 2018-08-26 |
| 1033603378 | Craig Allen Gillett | Marriage & Family Therapist | 11847 Wilshire Blvd., #300, Los Angeles, CA 90025 | 2018-06-20 |
| Find all providers in zip 90025 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437766920 | Mary Mekhael | Optometrist | 5901 Center Dr Apt 456, Los Angeles, CA 90045-8969 | 2020-09-28 |
| 1013524677 | Jennifer Dang, O.d., A Professional Corporation | Optometrist | 301 S Western Ave Ste 103, Los Angeles, CA 90020-3816 | 2020-09-28 |
| 1467064766 | Quynh Trang Diep | Optometrist | 222 S Central Ave Apt 400, Los Angeles, CA 90012-4231 | 2020-08-18 |
| 1114547619 | Eyecare Specialists Medical Group, Inc. | Optometrist | 1711 W Temple St Ste 5665, Los Angeles, CA 90026-5421 | 2020-04-24 |
| 1487283362 | Daisy Lee Spearman | Optometrist | 5136 W Slauson Ave, Los Angeles, CA 90056-1641 | 2020-04-03 |
| 1376181768 | Nirlok Corporation | Optometrist | 750 West 7th Street, Los Angeles, CA 90017 | 2019-12-16 |
| 1841837242 | Hollywood Optometrist | Optometrist | 1300 N Vermont Ave Ste 703, Los Angeles, CA 90027-6089 | 2019-12-04 |
| 1770124570 | Manchester Optometry Eye Care | Optometrist | 10024 S Vermont Ave Ste 2, Los Angeles, CA 90044-3112 | 2019-10-02 |
| 1124588165 | Evelynne Chavez | Optometrist | 11301 Wilshire Blvd Bldg 304, Los Angeles, CA 90073-1003 | 2019-03-25 |
| 1467929265 | Galina Vardanyan | Optometrist | 621 S Western Ave Ste 214, Los Angeles, CA 90005 | 2018-10-30 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90025 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.