Provider Demographics
NPI:1891705869
Name:HO, CONNIE (MD)
Entity Type:Individual
Prefix:DR
First Name:CONNIE
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 1:882 EMERSON ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-2448
Mailing Address - Country:US
Mailing Address - Phone:650-323-8900
Mailing Address - Fax:650-323-8904
Practice Address - Street 1:882 EMERSON ST
Practice Address - Street 2:SUITE B
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2448
Practice Address - Country:US
Practice Address - Phone:650-323-8900
Practice Address - Fax:650-323-8904
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG82002173000000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered173000000XOther Service ProvidersLegal Medicine
Not Answered174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G820024Medicare ID - Type Unspecified
CAG18886Medicare UPIN