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FONTANA OPTOMETRIC GROUP INC. NPI 1972688513


NPI Information

NPI: 1972688513
Provider Name: FONTANA OPTOMETRIC GROUP, INC.

Former Legal Business Name: WILLIAM WONG AND DOUGLAS LEO, O.D.

Classification: Optometrist - 152W00000X
Entity Type: Organization
Address:
16866 SEVILLE AVE
FONTANA, CA
ZIP 92335
Phone: (909) 350-1524
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FONTANA OPTOMETRIC GROUP, INC. is an optometrist in Fontana, CA. The provider is 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. FONTANA OPTOMETRIC GROUP, INC. NPI is 1972688513. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is William Wong And Douglas Leo, O.d..

The provider's business location address is:

16866 SEVILLE AVE
FONTANA, CA
ZIP 92335-561
Phone: (909) 350-1524
Fax: (909) 350-8546

The provider's authorized official is Douglas J. Leo .
The authorized official title is Owner and has the following contact phone number (909) 428-2020.

The enumeration date for this NPI number is 10/25/2006 and was last updated on 2/20/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1152W00000XOptometrist06988CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1YYY48781YMEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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