Dr. Tracy Wong, O.D.
Optometrist in El Segundo, CA. Individual provider (NPI-1).
NPI number1821177239
StatusActive
Last updated in NPPESFeb 12, 2014
Details
- NPI
- 1821177239
- Entity type
- Individual (NPI-1)
- Name
- Dr. Tracy Wong
- Credential
- O.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 4, 2006
- Last updated
- Feb 12, 2014
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - OPTOMETRY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 12873 T | CA | Yes |
Practice location
2101 Rosecrans AveEl Segundo, CA 90245-4749
Phone 310-321-6990
Mailing address
2101 Rosecrans AveEl Segundo, CA 90245-4749
Phone 310-321-6990
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 16 Optometrist providers in El Segundo · All 6,342 providers in El Segundo
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