Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Deanna M Wong Wan, OD

Individual provider Optometrist · NPI 1104975580

Deanna M Wong Wan, OD is an Optometry in San Diego, California. Qualified in 1996, 30 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
30
Licensed in
CA
In the registry since
2007
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

4647 Zion Ave
San Diego, CA 92120-2507
Phone: (619) 528-5000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence OPT10793T (CA)

Record details

NPI number1104975580
Entity typeIndividual (Type 1)
GenderFemale
Credentials OD
Sole proprietorNo
NPI enumeratedJanuary 9, 2007
Last updated in NPPESNovember 30, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolOTHER
Graduated 1996 (30 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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