Provider Demographics
NPI:1003399304
Name:HOANG MINH HO, O.D, INC
Entity Type:Organization
Organization Name:HOANG MINH HO, O.D, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOANG
Authorized Official - Middle Name:
Authorized Official - Last Name:HO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-254-7632
Mailing Address - Street 1:4840 SHAWLINE ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-1400
Mailing Address - Country:US
Mailing Address - Phone:858-560-5742
Mailing Address - Fax:
Practice Address - Street 1:4840 SHAWLINE ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-1400
Practice Address - Country:US
Practice Address - Phone:858-560-5742
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-12
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty