Provider Demographics
NPI:1194854794
Name:HO, PAULINE (MD)
Entity Type:Individual
Prefix:
First Name:PAULINE
Middle Name:
Last Name:HO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20691 VIA VENTANA
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-4616
Mailing Address - Country:US
Mailing Address - Phone:714-283-2620
Mailing Address - Fax:
Practice Address - Street 1:1275 N ROSE DR
Practice Address - Street 2:SUITE 134
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-3941
Practice Address - Country:US
Practice Address - Phone:714-996-6500
Practice Address - Fax:714-996-1722
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA67636174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA67636BMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER