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NPI Code Detail

MEDICARE: CAROLE LISA HONG OD

MEDICARE: CAROLE LISA HONG OD
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
1152W00000XOptometrist9662TCA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11238570001OTHERCAMEDICARE SUPPLY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982685509
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLE LISA HONG OD
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 :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2005
Last Update Date : 01/29/2013

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Directions to “ CAROLE LISA HONG OD” Practice Location

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