Healthcare Provider Details

I. General information

NPI: 1932550910
Provider Name (Legal Business Name): ANDREW M HO D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2016
Last Update Date: 03/21/2022
Certification Date: 03/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2720 SOUTH ST STE 110
SANTA ANA CA
92704
US

IV. Provider business mailing address

6245 INKSTER RD
GARDEN CITY MI
48135-4001
US

V. Phone/Fax

Practice location:
  • Phone: 323-889-7830
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number18006
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number510122827
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: