Healthcare Provider Details

I. General information

NPI: 1598389363
Provider Name (Legal Business Name): JAMES C HO M.D. MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2020
Last Update Date: 10/14/2020
Certification Date: 10/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 SAN BERNARDINO RD STE G
UPLAND CA
91786-4980
US

IV. Provider business mailing address

500 N BELRIDGE TER
BREA CA
92821-7401
US

V. Phone/Fax

Practice location:
  • Phone: 714-290-7089
  • Fax: 909-972-0055
Mailing address:
  • Phone: 714-290-7089
  • Fax: 909-972-0055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES C HO
Title or Position: PRESIDENT
Credential: MD
Phone: 714-290-7089