Provider Demographics
NPI:1962465096
Name:HO, ANDREW PO-JUNG (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:PO-JUNG
Last Name:HO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:21840 NORMANDIE AVE
Mailing Address - Street 2:STE. 200
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-2047
Mailing Address - Country:US
Mailing Address - Phone:310-222-3113
Mailing Address - Fax:310-320-6973
Practice Address - Street 1:21840 NORMANDIE AVE
Practice Address - Street 2:STE. 200
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2047
Practice Address - Country:US
Practice Address - Phone:310-222-3113
Practice Address - Fax:310-320-6973
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG768982084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G768980Medicaid
CAWG76898BMedicare ID - Type UnspecifiedPPIN NUMBER
CAG57011Medicare UPIN
CAWG76898CMedicare ID - Type UnspecifiedPPIN NUMBER