HO, CHARLES P (MD)

Provider Demographics

• NPI: 1083690812
• Name: HO, CHARLES P (MD)
• Entity Type: Individual
• Prefix: DR
• First Name: CHARLES
• Middle Name: P
• Last Name: HO
• Gender: M
• Credentials: MD
• Mailing Address - Street 1: 181 W MEADOW DR STE 1000
• Mailing Address - City: VAIL
• Mailing Address - State: CO
• Mailing Address - Zip Code: 81657-5889
• Mailing Address - Country: US
• Mailing Address - Phone: 970-479-9797
• Mailing Address - Fax: 970-479-5819
• Practice Address - Street 1: 12605 E 16TH AVE
• Practice Address - City: AURORA
• Practice Address - State: CO
• Practice Address - Zip Code: 80045-2545
• Practice Address - Country: US
• Practice Address - Phone: 720-848-0000
• Is Sole Proprietor?: No
• Enumeration Date: 2005-12-22
• Last Update Date: 2019-05-15

Provider Licenses

State	License ID	Taxonomies
OK	21397	2085R0202X
TX	J6133	2085R0202X
WA	MD0032460	2085R0202X
AZ	34706	2085R0202X
NE	24348	2085R0202X
OH	35-06-4904-H	2085R0202X
NJ	MA72102	2085R0202X
NY	215113-1	2085R0202X
CA	G56084	2085R0202X
HI	12895	2085R0202X
IL	36103741	2085R0202X
MT	59	2085R0202X
CO	30704	2085R0202X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	2085R0202X	Allopathic & Osteopathic Physicians	Radiology	Diagnostic Radiology

Provider Identifiers

State	Identifier ID	ID Type	Issuer
OK	200097650A	Medicaid
CO	01307040	Medicaid
WA	8933493	Other	L&I CVCP
CA	300035774	Other	RAILROAD MEDICARE
NJ	8940401	Medicaid
WA	0144889	Other	L&I
CA	00G560840	Medicaid
WA	8169641	Medicaid
CA	00G5608415	Medicare PIN
OK	00G560841	Medicare PIN
CA	00G5608423	Medicare PIN
CA	00G560843	Medicare PIN
CA	00G560845	Medicare PIN
CA	00G5608413	Medicare PIN
WA	0144889	Other	L&I
CA	00G5608421	Medicare PIN
NJ	051036	Medicare PIN
WA	AB07763	Medicare PIN
CA	00G5608417	Medicare PIN
CA	00G5608414	Medicare PIN
CA	00G560840	Medicare PIN
CA	300035774	Other	RAILROAD MEDICARE
CA	E49221	Medicare UPIN
CA	00G560840	Medicaid
WA	8169641	Medicaid
CA	00G5908412	Medicare PIN
CO	293245YKQ8	Medicare PIN
CA	00G5608418	Medicare PIN
CA	00G5608416	Medicare PIN
CA	00G5608410	Medicare PIN
WA	8933493	Other	L&I CVCP
OK	200097650A	Medicaid
CA	00G560848	Medicare PIN
CA	00G560849	Medicare PIN
CO	01307040	Medicaid
CA	00G560842	Medicare PIN
CA	00G5608422	Medicare PIN
CA	00G5608411	Medicare PIN