Provider Demographics
NPI:1033350756
Name:PETER HO WIN MD INC
Entity Type:Organization
Organization Name:PETER HO WIN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:HO
Authorized Official - Last Name:WIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-447-7008
Mailing Address - Street 1:234 S 1ST AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-3607
Mailing Address - Country:US
Mailing Address - Phone:626-447-7008
Mailing Address - Fax:626-447-7009
Practice Address - Street 1:234 S 1ST AVE STE 101
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3607
Practice Address - Country:US
Practice Address - Phone:626-447-7008
Practice Address - Fax:626-447-7009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-09
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85277207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1033350756OtherMEDI-CAL PROVIDER ID
CABU912AOtherMEDICARE PTAN