=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518920230
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANDY TUAN HO, M.D., INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/11/2006
-----------------------------------------------------
Last Update Date | 08/24/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9081 BOLSA AVE STE 109
-----------------------------------------------------
City | WESTMINSTER
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92683-5590
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-891-7393
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9081 BOLSA AVE STE 109
-----------------------------------------------------
City | WESTMINSTER
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92683-5590
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-891-7393
-----------------------------------------------------
Fax | 714-891-7981
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. ANDY TUAN HO
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 714-891-7393
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | A72198
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------