Provider Demographics
NPI:1548685597
Name:FORISTER AND HONG OPTOMETRY
Entity type:Organization
Organization Name:FORISTER AND HONG OPTOMETRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HONG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:619-200-6890
Mailing Address - Street 1:28356 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-1434
Mailing Address - Country:US
Mailing Address - Phone:310-831-0841
Mailing Address - Fax:310-831-3369
Practice Address - Street 1:28356 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-1434
Practice Address - Country:US
Practice Address - Phone:310-831-0841
Practice Address - Fax:310-831-3369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-27
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12811TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty