Dr. Keith Yun Kong Wong
Optometrist

Address: 3401 Dale Rd, Suite 300, Modesto, CA 95356-0505
Phone: 2095740710

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).

Provider Overview

Nation Provider Identifier (NPI) 1336201615
Entity Type Individual
Full Name Dr. Keith Yun Kong Wong
Credential O.D.
Gender Male
Practice Address 3401 Dale Rd
Suite 300
Modesto
CA 95356-0505
Practice Telephone 2095740710
Practice Fax Number 2095299030
Mailing Address 1608 Lavender Ln
Modesto
CA 95355-3771
Mailing Telephone 2095215709
Sole Proprietor Yes, this individual is a Sole Proprietor
Enumeration Date 2006-12-14
Last Update Date 2015-10-20

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 152W00000X Optometrist Eye and Vision Services Providers 8152T CA

Other Provider Identifier

State Identifier Issuer Type Code
CA 8152T OTHER STATE LICENSE
CA CA8152 OTHER EYEMED
CA MW1207491 OTHER DEA
CA SD0081520 MEDICAID
CA 14062 OTHER MES

Providers with the same name

NPI Name Taxonomy Address Enumeration
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
1568950657 Keith Michael Wong Optometrist 870 Providence Hwy, Dedham, MA 02026 2018-04-25
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

Taxonomy Information

Taxonomy Code 152W00000X
Grouping Eye and Vision Services Providers
Classification Optometrist

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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
1194889220 Brendan Richard James Optometrist 1019 16th St, Modesto, CA 95354-1105 2006-12-21
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

Office Location

Street Address 3401 DALE RD
SUITE 300
City MODESTO
State CA
Zip Code 95356-0505

Providers in the same location

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 3401 Dale Rd, Vintage Faire Mall Ste 303, Modesto, CA 95356-0505 2006-12-27

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1689220279 Meagan Veneman Physical Medicine & Rehabilitation 125 Hogue Rd, Modesto, CA 95356 2019-08-10
1720432438 Anuradha Dubey, M.d., Inc Pediatrics 4312 Spyres Way, Modesto, CA 95356 2016-04-19
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

Competitor

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City MODESTO
Zip Code 95356

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Dataset Information

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.

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