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NPI Code Detail

MEDICARE: CAROLE L. HONG & KRISTINA STASKO, PTRS

MEDICARE: CAROLE L. HONG & KRISTINA STASKO, PTRS
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
1152WC0802XCorneal and Contact Management Optometrist8031TCA

General Provider Information

NPI Number : 1891976262
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAROLE L. HONG & KRISTINA STASKO, PTRS
Provider Business Mailing Address
First Line : 1234 CHERRY ST
Second Line :
City : SAN CARLOS
State : CA
Zip : 94070-3110
Country : US
Telephone Number : 650-593-1661
Fax Number : 650-595-5203
Provider Business Practice Location Address
First Line : 1234 CHERRY ST
Second Line :
City : SAN CARLOS
State : CA
Zip : 94070-3110
Country : US
Telephone Number : 650-593-1661
Fax Number : 650-595-5203
Authorized Official
Title or Position : PARTNER
Name : DR. KRISTINA STASKO
Credential : OD
Telephone Number : 650-593-1661
Provider Enumeration Date : 11/14/2007
Last Update Date : 12/02/2008

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