Provider Demographics
NPI:1447414180
Name:KAO, WEI HSIN (OD)
Entity Type:Individual
Prefix:
First Name:WEI
Middle Name:HSIN
Last Name:KAO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 S NOGALES ST #109
Mailing Address - Street 2:
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748
Mailing Address - Country:US
Mailing Address - Phone:626-428-9186
Mailing Address - Fax:626-965-8697
Practice Address - Street 1:1015 S NOGALES ST #109
Practice Address - Street 2:
Practice Address - City:ROWLAND HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91748
Practice Address - Country:US
Practice Address - Phone:626-428-9186
Practice Address - Fax:626-965-8697
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13531152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW15680A01OtherMEDICARE PTAN