Provider Demographics
NPI:1417097569
Name:TO, TERESA
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:TO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 CASTRO ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94041-2055
Mailing Address - Country:US
Mailing Address - Phone:650-965-3937
Mailing Address - Fax:650-965-1221
Practice Address - Street 1:650 CASTRO ST
Practice Address - Street 2:SUITE 150
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94041-2055
Practice Address - Country:US
Practice Address - Phone:650-965-3937
Practice Address - Fax:650-965-1221
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician