Provider Demographics
NPI:1689325409
Name:KATHERINE MAKAYED, O.D., INC.
Entity Type:Organization
Organization Name:KATHERINE MAKAYED, O.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAKAYED
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:408-779-5584
Mailing Address - Street 1:17190 MONTEREY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-3604
Mailing Address - Country:US
Mailing Address - Phone:408-779-5584
Mailing Address - Fax:
Practice Address - Street 1:17190 MONTEREY RD STE 100
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-3604
Practice Address - Country:US
Practice Address - Phone:408-779-5584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty