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General NPI Number Information
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NPI Number | 1891976262
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Entity Type | Organization
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Legal Business Name | CAROLE L. HONG & KRISTINA STASKO, PTRS
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Dates
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Enumeration Date | 11/14/2007
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Last Update Date | 12/02/2008
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Provider Practice Location Address
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Address Line | 1234 CHERRY ST
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City | SAN CARLOS
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State | CA
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Zip | 94070-3110
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Country | US
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Telephone | 650-593-1661
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Fax | 650-595-5203
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Provider Business Mailing Address
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Address Line | 1234 CHERRY ST
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City | SAN CARLOS
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State | CA
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Zip | 94070-3110
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Country | US
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Telephone | 650-593-1661
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Fax | 650-595-5203
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Authorized Official
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Title or Position | PARTNER
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Name | DR. KRISTINA STASKO
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Credential | OD
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Telephone | 650-593-1661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 8031T
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License Number State | CA
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