Provider Demographics
NPI:1689832636
Name:JAMES KAO OPHTHALMOLOGY CORP
Entity Type:Organization
Organization Name:JAMES KAO OPHTHALMOLOGY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:KAO
Authorized Official - Suffix:
Authorized Official - Credentials:DO, MD, MPH
Authorized Official - Phone:626-890-1899
Mailing Address - Street 1:6 CRANE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602-2417
Mailing Address - Country:US
Mailing Address - Phone:626-890-1899
Mailing Address - Fax:949-502-5522
Practice Address - Street 1:790 E COLORADO BLVD STE 100
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2178
Practice Address - Country:US
Practice Address - Phone:310-407-5440
Practice Address - Fax:310-407-5441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7960207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A7960OtherCALIFORNIA LICENCE
CAH98628Medicare UPIN