Provider Demographics
NPI:1053454249
Name:KAGAN, ALINA (OD)
Entity type:Individual
Prefix:
First Name:ALINA
Middle Name:
Last Name:KAGAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ALINA
Other - Middle Name:
Other - Last Name:KAGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:137 BAYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-1672
Mailing Address - Country:US
Mailing Address - Phone:650-759-8982
Mailing Address - Fax:
Practice Address - Street 1:1601 EL CAMINO REAL
Practice Address - Street 2:STE 302
Practice Address - City:BELMONT
Practice Address - State:CA
Practice Address - Zip Code:94002-3943
Practice Address - Country:US
Practice Address - Phone:650-654-2015
Practice Address - Fax:650-654-2014
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11666T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist