Provider Demographics
NPI:1154412690
Name:MORIOKA, KATHERINE HIROMI (OD OPTOMETRIST)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:HIROMI
Last Name:MORIOKA
Suffix:
Gender:F
Credentials:OD OPTOMETRIST
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Mailing Address - Street 1:530 BUSH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108
Mailing Address - Country:US
Mailing Address - Phone:415-291-8560
Mailing Address - Fax:415-291-8573
Practice Address - Street 1:530 BUSH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108
Practice Address - Country:US
Practice Address - Phone:415-291-8560
Practice Address - Fax:415-291-8573
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAOPT8287TPA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4404682OtherAETNA
CASD0082870OtherBLUE SHIELD OF CA
CA2285200OtherFIRST HEALTH CCN