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General NPI Number Information
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NPI Number | 1154843779
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Entity Type | Individual
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Provider Name | KATHERINE MAKEDONSKY OD
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Gender | Female
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Dates
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Enumeration Date | 07/14/2017
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 847 MARINA VILLAGE PKWY
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City | ALAMEDA
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State | CA
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Zip | 94501-1035
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Country | US
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Telephone | 510-337-7970
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Fax | 510-337-7973
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Provider Business Mailing Address
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Address Line | 1234 MOUNTAIN SIDE CT
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City | CONCORD
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State | CA
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Zip | 94521-5508
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Country | US
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Telephone | 925-457-8632
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT33727TLG
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License Number State | CA
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