Provider Demographics
NPI:1942919212
Name:HO, AGATA
Entity Type:Individual
Prefix:
First Name:AGATA
Middle Name:
Last Name:HO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14361 PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-4423
Mailing Address - Country:US
Mailing Address - Phone:714-464-9336
Mailing Address - Fax:
Practice Address - Street 1:500 UNIVERSITY AVE STE 110
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6537
Practice Address - Country:US
Practice Address - Phone:916-452-3454
Practice Address - Fax:916-452-3455
Is Sole Proprietor?:No
Enumeration Date:2022-11-16
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA87179183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist