Provider Demographics
NPI:1467478933
Name:HO, MINDY (DC)
Entity type:Individual
Prefix:DR
First Name:MINDY
Middle Name:
Last Name:HO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 N ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:LA PUENTE
Mailing Address - State:CA
Mailing Address - Zip Code:91744-1735
Mailing Address - Country:US
Mailing Address - Phone:626-922-3115
Mailing Address - Fax:
Practice Address - Street 1:2171 S GROVE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-4600
Practice Address - Country:US
Practice Address - Phone:909-923-4080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29186111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAV07513Medicare UPIN