Organization Active NPI

Hoang Minh Ho, O.D, Inc

  • Optometrist
  • San Diego, CA
National Provider Identifier
1003399304
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
HOANG MINH HO, O.D, INC
Practice address
4840 Shawline St
San Diego, CA 92111-1400
Phone
(858) 560-5742
NPI assigned
Sep 12, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Hoang HoNPI 1275684847
Title
President
Phone
(858) 254-7632

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

4840 Shawline St
San Diego, CA 92111-1400

Mailing address

4840 Shawline St
San Diego, CA 92111-1400
Phone (858) 560-5742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250819003803 CA Part B Supplier - Clinic/Group Practice 4789045246 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1536710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640649600000",
    "number": "1003399304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4840 SHAWLINE ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921111400",
            "telephone_number": "858-560-5742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4840 SHAWLINE ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921111400",
            "telephone_number": "858-560-5742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOANG MINH HO, O.D, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-12",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A",
        "authorized_official_last_name": "HO",
        "authorized_official_first_name": "HOANG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-254-7632"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.