Provider Demographics
NPI:1972839959
Name:HO, LIGONG LEON (LAC)
Entity Type:Individual
Prefix:
First Name:LIGONG
Middle Name:LEON
Last Name:HO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4826 BALTHAZAR TER
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94555-2623
Mailing Address - Country:US
Mailing Address - Phone:510-378-6133
Mailing Address - Fax:
Practice Address - Street 1:100 N WINCHESTER BLVD
Practice Address - Street 2:SUITE 390
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-6520
Practice Address - Country:US
Practice Address - Phone:510-378-6133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-26
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 13121171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist