Individual
CAROLE LISA HONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1234 CHERRY ST, SAN CARLOS, CA 94070-3110
(650) 593-1661
(650) 595-5203
Mailing address
1234 CHERRY ST, SAN CARLOS, CA 94070-3110
(650) 593-1661
(650) 595-5203
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9662T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1238570001
MEDICARE SUPPLY
CA
05
—
YYY48725Y
—
CA
Enumeration date
11/10/2005
Last updated
01/29/2013
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