Provider Demographics
NPI:1215066717
Name:JOSEPH M. HO M.D., INC.
Entity type:Organization
Organization Name:JOSEPH M. HO M.D., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:M
Authorized Official - Last Name:HO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-962-1028
Mailing Address - Street 1:15201 ELEVENTH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-3735
Mailing Address - Country:US
Mailing Address - Phone:760-962-1028
Mailing Address - Fax:760-843-8486
Practice Address - Street 1:15201 ELEVENTH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-3735
Practice Address - Country:US
Practice Address - Phone:760-962-1028
Practice Address - Fax:760-843-8486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG73155261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF27374Medicare UPIN