Provider Demographics
NPI:1588705362
Name:HO, SHEAU-LIN (MD)
Entity type:Individual
Prefix:
First Name:SHEAU-LIN
Middle Name:
Last Name:HO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:THOMAS SHEAU-LIN
Other - Middle Name:
Other - Last Name:HO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2512 SAMARITAN CT
Mailing Address - Street 2:SUITE H
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-4002
Mailing Address - Country:US
Mailing Address - Phone:408-358-2681
Mailing Address - Fax:
Practice Address - Street 1:2512 SAMARITAN CT
Practice Address - Street 2:SUITE H
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-4002
Practice Address - Country:US
Practice Address - Phone:408-358-2681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA 42510208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
F49715Medicare UPIN