Provider Demographics
NPI:1285933945
Name:HO, JACQUELINE R (MD)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:R
Last Name:HO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:13950 MILTON AVE STE 402
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-2939
Mailing Address - Country:US
Mailing Address - Phone:714-702-3000
Mailing Address - Fax:714-702-3039
Practice Address - Street 1:510 N PROSPECT AVE STE 202
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-3030
Practice Address - Country:US
Practice Address - Phone:310-318-3010
Practice Address - Fax:310-798-7304
Is Sole Proprietor?:No
Enumeration Date:2011-03-21
Last Update Date:2023-01-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA122858207V00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARES000Medicare UPIN