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General NPI Number Information
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NPI Number | 1487798443
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Entity Type | Organization
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Legal Business Name | ELVIN HO OD PC
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4505 E MCKELLIPS RD VISION CENTER
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City | MESA
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State | AZ
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Zip | 85215
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Country | US
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Telephone | 480-626-5127
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Fax | 480-240-1588
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Provider Business Mailing Address
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Address Line | 500 N ESTRELLA PKWY STE B2 480
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City | GOODYEAR
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State | AZ
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Zip | 85338
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Country | US
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Telephone | 480-626-5127
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Fax | 480-240-1588
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Authorized Official
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Title or Position | PRESIDENT
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Name | ELVIN HO
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Credential | O.D.
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Telephone | 480-626-5127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1165
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License Number State | AZ
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