Provider Demographics
NPI:1205002847
Name:PAO, KRISTINA YI-HWA (MD)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:YI-HWA
Last Name:PAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 C G ZINN RD
Mailing Address - Street 2:
Mailing Address - City:THORNDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19372-1134
Mailing Address - Country:US
Mailing Address - Phone:610-384-9100
Mailing Address - Fax:610-384-3937
Practice Address - Street 1:3000 C G ZINN RD
Practice Address - Street 2:
Practice Address - City:THORNDALE
Practice Address - State:PA
Practice Address - Zip Code:19372-1134
Practice Address - Country:US
Practice Address - Phone:610-384-9100
Practice Address - Fax:610-384-3937
Is Sole Proprietor?:No
Enumeration Date:2008-05-04
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD480001174400000X, 207WX0200X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No174400000XOther Service ProvidersSpecialist
No207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2044942Medicaid
OH2044942Medicaid
OH9922901Medicare PIN