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General NPI Number Information
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NPI Number | 1245741537
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Entity Type | Individual
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Provider Name | KATHERINE MAKAYED OD
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Gender | Female
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Dates
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Enumeration Date | 10/13/2017
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Last Update Date | 10/20/2021
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Provider Practice Location Address
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Address Line | 17190 MONTEREY RD STE 100
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City | MORGAN HILL
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State | CA
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Zip | 95037-3604
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Country | US
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Telephone | 408-779-5584
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Fax | 408-779-6819
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Provider Business Mailing Address
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Address Line | 5261 MILL CREEK LN
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City | SAN JOSE
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State | CA
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Zip | 95136-3612
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Country | US
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Telephone | 929-437-3937
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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 | OPT33743-TLG
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License Number State | CA
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