Provider Demographics
NPI:1043594823
Name:HO, BRIAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:HO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:293 CALLE LA MONTANA
Mailing Address - Street 2:
Mailing Address - City:MORAGA
Mailing Address - State:CA
Mailing Address - Zip Code:94556-1609
Mailing Address - Country:US
Mailing Address - Phone:925-890-4983
Mailing Address - Fax:
Practice Address - Street 1:1050 REDWOOD ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-2955
Practice Address - Country:US
Practice Address - Phone:707-557-6948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA66129183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist