Provider Demographics
NPI:1598702177
Name:HO, KALON KWUN LEUNG (MD, MSC)
Entity Type:Individual
Prefix:
First Name:KALON
Middle Name:KWUN LEUNG
Last Name:HO
Suffix:
Gender:M
Credentials:MD, MSC
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Other - First Name:
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Mailing Address - Street 1:330 BROOKLINE AVE
Mailing Address - Street 2:BIDMC, BAKER 4
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5491
Mailing Address - Country:US
Mailing Address - Phone:617-667-8800
Mailing Address - Fax:617-632-7460
Practice Address - Street 1:330 BROOKLINE AVE
Practice Address - Street 2:BIDMC, BAKER 4
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5491
Practice Address - Country:US
Practice Address - Phone:617-667-8800
Practice Address - Fax:617-632-7460
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2012-11-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA76842207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3137261Medicaid
MAG00936Medicare UPIN
MA3137261Medicaid