Provider Demographics
NPI:1629245014
Name:FOK, HENRY K (OD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:K
Last Name:FOK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:907 TASSASARA DR
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-4557
Mailing Address - Country:US
Mailing Address - Phone:408-946-2279
Mailing Address - Fax:
Practice Address - Street 1:1818 TULLY RD
Practice Address - Street 2:#158B
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-1883
Practice Address - Country:US
Practice Address - Phone:408-274-0998
Practice Address - Fax:408-274-2060
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6216152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist