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General NPI Number Information
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NPI Number | 1801429402
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Entity Type | Individual
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Provider Name | KATHERINE TAI OD
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Gender | Female
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Dates
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Enumeration Date | 02/21/2020
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Last Update Date | 02/21/2020
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Provider Practice Location Address
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Address Line | 46324 WARM SPRINGS BLVD UNIT 747
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City | FREMONT
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State | CA
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Zip | 94539-7998
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Country | US
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Telephone | 510-490-2010
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Fax |
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Provider Business Mailing Address
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Address Line | 138 N MILPITAS BLVD
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City | MILPITAS
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State | CA
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Zip | 95035-4401
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Country | US
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Telephone |
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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 | OPT34480TLG
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License Number State | CA
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