Wong, Clinton King

Wong, Clinton King is an sole proprietor health care provider with primary practice located at 12810 Heacock St Suite B104, Moreno Valley CA 92553-2854. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Wong, Clinton King can be contacted via phone (951) 924-2020.

Contact Information

Primary practice address
12810 Heacock St Suite B104 Moreno Valley CA 92553-2854
Phone: (951) 924-2020
Fax: (951) 924-7136
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 7725T California

Profile Details

NPI number 1619003944
LBN Legal business name Wong, Clinton King
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 23rd, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619003944 NPPES
California MEDICAID SD0077250

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