Provider Demographics
NPI:1659500726
Name:SERENA HO, O.D. APC
Entity Type:Organization
Organization Name:SERENA HO, O.D. APC
Other - Org Name:DESERT EYEWORKS OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SERENA
Authorized Official - Middle Name:
Authorized Official - Last Name:HO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:760-779-8282
Mailing Address - Street 1:73111 COUNTRY CLUB DR
Mailing Address - Street 2:STE #B-3
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-2340
Mailing Address - Country:US
Mailing Address - Phone:760-779-8282
Mailing Address - Fax:760-779-0606
Practice Address - Street 1:73111 COUNTRY CLUB DR
Practice Address - Street 2:STE #B-3
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-2340
Practice Address - Country:US
Practice Address - Phone:760-779-8282
Practice Address - Fax:760-779-0606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12583TPA152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty