Healthcare Provider Details

I. General information

NPI: 1861292328
Provider Name (Legal Business Name): MATTHEW MINH HO CPO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2025
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 STOCKTON BLVD
SACRAMENTO CA
95817-2215
US

IV. Provider business mailing address

2900 N ROCKY POINT DR
TAMPA FL
33607-1460
US

V. Phone/Fax

Practice location:
  • Phone: 916-453-2170
  • Fax: 916-453-5024
Mailing address:
  • Phone: 813-281-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License NumberCPO05274
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License NumberCPO05274
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: