Provider Demographics
NPI:1124351440
Name:HO, KATE (OD)
Entity type:Individual
Prefix:DR
First Name:KATE
Middle Name:
Last Name:HO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20932 BROOKHURST ST STE 208
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-6684
Mailing Address - Country:US
Mailing Address - Phone:714-962-3371
Mailing Address - Fax:
Practice Address - Street 1:20932 BROOKHURST ST STE 208
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92646-6684
Practice Address - Country:US
Practice Address - Phone:714-962-3371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-18
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13860152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADJ274AMedicare PIN