Healthcare Provider Details

I. General information

NPI: 1518293943
Provider Name (Legal Business Name): ANTHONY HUNG QUAN HO D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2009
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2975 SYCAMORE DR
SIMI VALLEY CA
93065-1201
US

IV. Provider business mailing address

1525 AVIATION BLVD # A1
REDONDO BEACH CA
90278-2805
US

V. Phone/Fax

Practice location:
  • Phone: 805-988-6100
  • Fax:
Mailing address:
  • Phone: 424-262-0243
  • Fax: 844-455-5074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number20A10893
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number20A10893
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number20A10893
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: