Provider Demographics
NPI:1518920230
Name:ANDY TUAN HO, M.D., INC.
Entity Type:Organization
Organization Name:ANDY TUAN HO, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:TUAN
Authorized Official - Last Name:HO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-891-7393
Mailing Address - Street 1:9081 BOLSA AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5590
Mailing Address - Country:US
Mailing Address - Phone:714-891-7393
Mailing Address - Fax:714-891-7981
Practice Address - Street 1:9081 BOLSA AVE STE 109
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5590
Practice Address - Country:US
Practice Address - Phone:714-891-7393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-11
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72198207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A721980Medicaid
H60447Medicare UPIN
CACB236243Medicare PIN