Provider Demographics
NPI:1417969650
Name:HO, VIET HUY (MD)
Entity Type:Individual
Prefix:
First Name:VIET
Middle Name:HUY
Last Name:HO
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 1:2299 BACON ST
Mailing Address - Street 2:STE 11
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-2046
Mailing Address - Country:US
Mailing Address - Phone:925-798-2020
Mailing Address - Fax:925-798-2004
Practice Address - Street 1:2299 BACON ST STE 11
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520
Practice Address - Country:US
Practice Address - Phone:925-798-2020
Practice Address - Fax:925-798-2004
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA92798207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A927980Medicaid
CA00A927980OtherPERFORMING PROVIDER IDENTIFICATION NUMBER
CA00A927980Medicaid