MEDICARE: SERENA HO O D A PROFESSIONAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152WC0802X	Corneal and Contact Management Optometrist	12583TPA	CA

General Provider Information

NPI Number	:	1659500726
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENA HO O D A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	73111 COUNTRY CLUB DR STE B3
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92260-2340
Country	:	US
Telephone Number	:	760-779-8282
Fax Number	:	760-779-0606

Provider Business Practice Location Address
First Line	:	73111 COUNTRY CLUB DR
Second Line	:	STE #B-3
City	:	PALM DESERT
State	:	CA
Zip	:	92260-2340
Country	:	US
Telephone Number	:	760-779-8282
Fax Number	:	760-779-0606

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SERENA HO
Credential	:	O.D.
Telephone Number	:	760-779-8282

Provider Enumeration Date	:	07/09/2009
Last Update Date	:	03/04/2026

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