DR. KEITH YUN KONG WONG (NPI# 1336201615) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1336201615 |
Entity Type | Individual |
Full Name | DR. KEITH YUN KONG WONG |
Credential | O.D. |
Practice Address |
3401 Dale Rd Suite 300 Modesto CA 95356-0505 |
Mailing Address |
1608 Lavender Ln Modesto CA 95355-3771 |
Practice Telephone | 2095740710 |
Practice Fax Number | 2095299030 |
Mailing Telephone | 2095215709 |
Enumeration Date | 2006-12-14 |
Last Update Date | 2015-10-20 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 152W00000X | Optometrist | 8152T | CA | Eye and Vision Services Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | STATE LICENSE | 8152T | 01 |
CA | EYEMED | CA8152 | 01 |
CA | DEA | MW1207491 | 01 |
CA | SD0081520 | 05 | |
CA | MES | 14062 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568950657 | Keith Michael Wong | Optometrist | 13662 Jamboree Rd Ste A, Irvine, CA 92602-1224 | 2018-04-25 |
1629326962 | Keith B Wong | Dentist | 1818 E Mercer St, Suite 200, Seattle, WA 98112-4687 | 2012-08-16 |
1538283536 | Keith Hon Wing Wong | Chiropractor | 1089 N Salem Dr, Schaumburg, IL 60194-1331 | 2007-03-17 |
1487739124 | Keith Lew Wong | Physical Therapist | 821 Harrison St, Oakland, CA 94607-4422 | 2006-10-25 |
1952840738 | Keith Wong | Counselor | 1500 Franklin St, San Francisco, CA 94109-4523 | 2017-02-14 |
1104200922 | Keith Wong | Family Medicine | 1403 Lomita Blvd, Suite 100, Harbor City, CA 90710-2076 | 2015-07-10 |
1598083388 | Keith Richard Wong | Pharmacist | 4955 Highway 6 N, Houston, TX 77084-2718 | 2010-05-04 |
Street Address |
3401 DALE RD SUITE 300 |
City | MODESTO |
State | CA |
Zip Code | 95356-0505 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497037428 | Daljit Srai Optometric Corporation | Optometrist | 3401 Dale Rd, Modesto, CA 95356-0505 | 2011-09-15 |
1447374608 | Theresa Kathryn Wilksen | Audiologist | 3401 Dale Rd, Modesto, CA 95356-0505 | 2007-03-16 |
1760547756 | Pearle Visioncare Inc | Eyewear Supplier (Equipment, not the service) | 3401 Dale Rd, Vintage Faire Mall Ste 303, Modesto, CA 95356-0505 | 2006-12-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649809021 | Amelia E Delgadillo | Licensed Vocational Nurse | 501 Triangle Rd, Modesto, CA 95356 | 2020-04-07 |
1689220279 | Meagan Veneman | Physical Medicine & Rehabilitation | 125 Hogue Rd, Modesto, CA 95356 | 2019-08-10 |
1497131213 | Hermes Guardian Transport | Non-emergency Medical Transport (VAN) | 4221 Erin Way, Modesto, CA 95356 | 2015-08-04 |
1811373640 | Melissa Ruiz | Marriage & Family Therapist | 5815 Stoddard Rd Suite 600, Modesto, CA 95356 | 2015-08-04 |
1922242866 | Lifecare Solutions Inc | Durable Medical Equipment & Medical Supplies | 500 Glass Ln Ste H, Modesto, CA 95356 | 2009-04-22 |
1659541647 | Ashley Allison Streeter | Dentist | 556 Lyell Dr, Modesto, CA 95356 | 2008-03-05 |
1265636013 | Margaret Kathleen Grisell | Orthopaedic Surgery | 4601 Dale Ave, Kaiser Modesto Medical Center, Orthopedic Surgery, Modesto, CA 95356 | 2007-06-14 |
1841412111 | Bobby Gene Boswell | Specialist/Technologist | 3908 Vintage Cove, Modesto, CA 95356 | 2007-05-03 |
1598892861 | Merritt Radiological Medical Group Inc | Radiology | 526 Charity Way, Modesto, CA 95356 | 2007-02-27 |
1396871091 | Michael Steven Beck | Social Worker | 4640 Spyres Way, Building B, Suite 7, Modesto, CA 95356 | 2007-02-26 |
Find all providers in zip 95356 |
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 |
---|---|---|---|---|
1982211793 | I To I LLC | Optometrist | 3401 Oakdale Rd, Ste 525, Modesto, CA 95355 | 2020-09-25 |
1578913869 | Lidia Tekie | Optometrist | 1208 Floyd Ave Bldg C, Modesto, CA 95350-2470 | 2016-06-16 |
1215186598 | Lina Lee | Optometrist | 3200 Sisk Rd, Modesto, CA 95356-0546 | 2008-09-11 |
1366600082 | Peter S. Klem Fred P. Guarcello Ptr | Optometrist | 4028 Dale Road, Suite 102, Modesto, CA 95356-9561 | 2008-05-29 |
1104001965 | Erika Bray Ortega | Optometrist | 2401 E Orangeburg Ave Ste 280, Modesto, CA 95355-3396 | 2007-12-29 |
1114131141 | Stanislaus Optometric Center, Inc. | Optometrist | 4028 Dale Rd Ste 102, Modesto, CA 95356-9505 | 2007-05-09 |
1255450524 | Richard Alan Portillo | Optometrist | 1624 I St, Modesto, CA 95354-1122 | 2007-03-28 |
1619028842 | Lincoln Andrus Service Jr. | Optometrist | 3500 Sisk Rd, Best Plaza Ste E, Modesto, CA 95356-0550 | 2007-01-15 |
1760558498 | L Edward Elliott Et Al Ptr Elliott L Edward Gen Ptr | Optometrist | 3601 Coffee Rd, Modesto, CA 95355 | 2006-11-27 |
1336213735 | Eric E Miedema | Optometrist | 1700 Mchenry Avenue, Suite 77, Modesto, CA 95350-4318 | 2006-11-17 |
Find all providers in MODESTO |
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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.