Healthcare Provider Details

I. General information

NPI: 1154469468
Provider Name (Legal Business Name): HO HAC CAO D.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 S PARK VICTORIA DR
MILPITAS CA
95035-5724
US

IV. Provider business mailing address

118 S PARK VICTORIA DR
MILPITAS CA
95035-5724
US

V. Phone/Fax

Practice location:
  • Phone: 408-934-9867
  • Fax: 408-934-9868
Mailing address:
  • Phone: 408-934-9867
  • Fax: 408-934-9868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number43119
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: