Provider Demographics
NPI:1124040209
Name:WIN, PETER HO (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:HO
Last Name:WIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234S 1ST AVE 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
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85277207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A852770Medicaid
P00476448OtherMEDICARE RAILROD PTAN
P00476448OtherMEDICARE RAILROD PTAN
CAWA85277CMedicare PIN
CAAW693Medicare PIN