Healthcare Provider Details
I. General information
NPI: 1023830288
Provider Name (Legal Business Name): HO MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/29/2024
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
929 CLAY ST STE 401
SAN FRANCISCO CA
94108-1556
US
IV. Provider business mailing address
929 CLAY ST STE 401
SAN FRANCISCO CA
94108-1556
US
V. Phone/Fax
- Phone: 415-982-4100
- Fax: 628-228-3197
- Phone: 415-982-4100
- Fax: 628-228-3197
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GUSTIN
MING-SUN
HO
Title or Position: PRESIDENT
Credential: MD
Phone: 415-982-4100