Provider Demographics
NPI:1013901271
Name:HO, TIMOTHY C (DPM)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:C
Last Name:HO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:T
Other - Middle Name:C
Other - Last Name:HO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPM
Mailing Address - Street 1:3114 SILBURY CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-3649
Mailing Address - Country:US
Mailing Address - Phone:408-445-0128
Mailing Address - Fax:408-445-0129
Practice Address - Street 1:3150 ALMADEN EXPY
Practice Address - Street 2:STE 231A
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95118-1250
Practice Address - Country:US
Practice Address - Phone:408-445-0128
Practice Address - Fax:408-445-0129
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-02
Last Update Date:2020-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4451213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2966435Medicaid
CAPO0222676OtherRAILROAD MEDICARE
CA000E44510Medicare ID - Type UnspecifiedBILLING
CAPO0222676OtherRAILROAD MEDICARE
CAU76586Medicare UPIN