Healthcare Provider Details

I. General information

NPI: 1467267658
Provider Name (Legal Business Name): TRI HO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2025
Last Update Date: 02/12/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1180 N CHERRY WAY
ANAHEIM CA
92801-2023
US

IV. Provider business mailing address

1180 N CHERRY WAY
ANAHEIM CA
92801-2023
US

V. Phone/Fax

Practice location:
  • Phone: 714-865-2803
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95032715
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number95032715
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: