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NPI Code Detail

MEDICARE: HOANG MINH HO O.D.

MEDICARE: HOANG MINH HO O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist12582TPACA

General Provider Information

NPI Number : 1275684847
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOANG MINH HO O.D.
Provider Business Mailing Address
First Line : 4840 SHAWLINE ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92111-1400
Country : US
Telephone Number : 858-560-5742
Fax Number : 858-569-6596
Provider Business Practice Location Address
First Line : 4840 SHAWLINE ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92111-1400
Country : US
Telephone Number : 858-560-5742
Fax Number : 858-569-6596
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2007
Last Update Date : 01/11/2022

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