Keith M Wong, OD
Optometrist in Fountain Valley, California
1568950657- Practice location
- 18120 Brookhurst St, Ste 19, Fountain Valley, CA 92708-6727
- Phone
- 949-208-9009
- Fax
- —
- Last updated
- December 16, 2025
Keith Michael Wong is an Optometrist based in Fountain Valley, CA. Keith Michael Wong practices in Fountain Valley, CA and has the professional credentials of OD. The NPI Number for Keith Michael Wong is 1568950657 and holds a License No. ODP-100657 (ID). The current practice location address for Keith Michael Wong is 18120 Brookhurst St, Ste 19, Fountain Valley, CA 92708-6727 and can be reached out via phone at 949-208-9009.
Provider Profile Details
- NPI Number
- 1568950657
- Provider Name
- Keith Michael Wong
- Credential
- OD
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 18120 Brookhurst St, Ste 19, Fountain Valley, CA 92708-6727
- Phone Number
- 949-208-9009
- Primary Taxonomy
- Optometrist · 152W00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- April 25, 2018
- Last Update Date
- December 16, 2025
- Certification Date
- December 16, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 18120 Brookhurst St
Ste 19
Fountain Valley, CA 92708-6727 - City
- Fountain Valley
- State
- California
- Zip
- 92708-6727
- Phone Number
- 949-208-9009
Provider Business Mailing Address Details
- Address
- 18120 Brookhurst St
Ste 19
Fountain Valley, CA 92708-6727 - City
- Fountain Valley
- State
- CA
- Zip
- 92708-6727
- Phone Number
- 714-508-4975
License Information
- License Number (1)
- ODP-100657
- License State (1)
- ID
- Taxonomy (1)
- Optometrist · 152W00000X
- License Number (2)
- 34715
- License State (2)
- CA
- Taxonomy (2)
- Optometrist · 152W00000X · Primary
- License Number (3)
- 11124T
- License State (3)
- TX
- Taxonomy (3)
- Optometrist · 152W00000X
- License Number (4)
- 5295
- License State (4)
- MA
- Taxonomy (4)
- Optometrist · 152W00000X
- License Number (5)
- OPT-OPT-LIC-5171
- License State (5)
- MT
- Taxonomy (5)
- Optometrist · 152W00000X
- License Number (6)
- 011064
- License State (6)
- NY
- Taxonomy (6)
- Optometrist · 152W00000X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Optometrists near Fountain Valley, CA
View all Optometrists in Fountain Valley →Frequently Asked Questions
What is the NPI number of Keith M Wong, OD?
The NPI number of Keith M Wong, OD is 1568950657. It was assigned on April 25, 2018 and is currently active in the NPPES registry.
What is the specialty of Keith M Wong, OD?
Keith M Wong, OD is registered under the primary taxonomy Optometrist (code 152W00000X), licensed in ID under license number ODP-100657.
Where does Keith M Wong, OD practice?
The practice location is 18120 Brookhurst St, Ste 19, Fountain Valley, CA 92708-6727. The office can be reached at 949-208-9009 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1568950657 directly on the NPPES registry website.