Provider Demographics
NPI:1659680411
Name:HO, SANDRA ANN (MD)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:ANN
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 1:11965 VENICE BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-3979
Mailing Address - Country:US
Mailing Address - Phone:310-876-0248
Mailing Address - Fax:310-684-2021
Practice Address - Street 1:11965 VENICE BLVD STE 300
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-3979
Practice Address - Country:US
Practice Address - Phone:310-876-0248
Practice Address - Fax:310-684-2021
Is Sole Proprietor?:No
Enumeration Date:2010-09-28
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA113522207K00000X
TXP2260207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology