Healthcare Provider Details

I. General information

NPI: 1518607852
Provider Name (Legal Business Name): WILSON HO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2022
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 HAYES ST 3RD FLOOR
SAN FRANCISCO CA
94117-1012
US

IV. Provider business mailing address

2250 HAYES ST 3RD FLOOR
SAN FRANCISCO CA
94117-1012
US

V. Phone/Fax

Practice location:
  • Phone: 415-668-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA209068
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: