Provider Demographics
NPI:1619945722
Name:PESCHKE, KAREN LILYAN (OD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:LILYAN
Last Name:PESCHKE
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 1:4934 COLUSA DR
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-5400
Mailing Address - Country:US
Mailing Address - Phone:818-416-7483
Mailing Address - Fax:
Practice Address - Street 1:181 S RANCHO SANTA FE RD
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-2501
Practice Address - Country:US
Practice Address - Phone:760-744-3002
Practice Address - Fax:760-744-3050
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12260T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist