MEDICARE: KRISTIN UCHIZONO O.D.

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	152W00000X	Optometrist	33599	CA

General Provider Information

NPI Number	:	1689125502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN UCHIZONO O.D.

Provider Business Mailing Address
First Line	:	18151 PALMETTO CIR
Second Line	:
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92708-5752
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16450 BOLSA CHICA ST
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649-2603
Country	:	US
Telephone Number	:	714-840-1366
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2016
Last Update Date	:	10/23/2024

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