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NPI 1245624162

NPI 1245624162 : DIEP NGOC HO M.D. : LA MESA, CA

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General NPI Number Information
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    NPI Number           |    1245624162
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    Entity Type          |    Individual 
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    Provider Name        |    DIEP NGOC HO M.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/28/2015
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    Last Update Date     |    11/27/2018
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Provider Practice Location Address
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    Address Line         |    10862 CALLE VERDE 
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    City                 |    LA MESA
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    State                |    CA
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    Zip                  |    91941-4307
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    Country              |    US
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    Telephone            |    619-660-1827
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    Fax                  |    619-660-1856
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Provider Business Mailing Address
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    Address Line         |    10790 RANCHO BERNARDO RD. 
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    City                 |    SAN DIEGO
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    State                |    CA
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    Zip                  |    92127-5705
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    Country              |    US
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    Telephone            |    619-660-1827
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    Fax                  |    619-660-1856
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    A148704
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    License Number State |    CA
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