Provider Demographics
NPI:1205002847
Name:PAO, KRISTINA YI-HWA (MD)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:YI-HWA
Last Name:PAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7003 PEARL RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44130-4941
Mailing Address - Country:US
Mailing Address - Phone:440-888-2333
Mailing Address - Fax:440-888-2335
Practice Address - Street 1:7003 PEARL RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-4941
Practice Address - Country:US
Practice Address - Phone:440-888-2333
Practice Address - Fax:440-888-2335
Is Sole Proprietor?:No
Enumeration Date:2008-05-04
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-122405174400000X, 207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2044942Medicaid
OH2044942Medicaid
OH9922901Medicare PIN