Provider Demographics
NPI:1063901957
Name:HO, PETER Q (MS, CPO)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:Q
Last Name:HO
Suffix:
Gender:M
Credentials:MS, CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 DI SALVO AVE STE 60
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-1714
Mailing Address - Country:US
Mailing Address - Phone:408-217-9387
Mailing Address - Fax:408-564-0138
Practice Address - Street 1:123 DI SALVO AVE STE 60
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1714
Practice Address - Country:US
Practice Address - Phone:408-217-9387
Practice Address - Fax:408-564-0138
Is Sole Proprietor?:No
Enumeration Date:2018-05-07
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1497893788Medicaid