Active NPI
Hoang Minh Ho, O.D.
- Optometrist
- San Diego, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 12582TPA
- Practice address
- 4840 Shawline St
San Diego, CA 92111-1400 - Phone
- (858) 560-5742
- Fax
- (858) 569-6596
- NPI assigned
- Jan 12, 2007
- Last updated
- Jan 11, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 12582TPA | CA | 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
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12582 | CA | MD | Dental Hygienist |
| 12582TPA | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hoang Minh Ho, O.D, Inc | Optometrist | Current | Accepting new patients |
| Legacy MD Medical Group Inc | Current | Accepting new patients | |
| Imperial Manor Skilled Nursing Inc | Current | Accepting new patients | |
| Legacy MD Medical Group Inc | Past | Accepting new patients |
Locations
290 Main St
Brawley, CA 92227
Phone (760) 352-2551
222 E Cole Blvd
Calexico, CA 92231
Phone (760) 352-2551
222 E Cole Blvd
Ste C
Calexico, CA 92231
Phone (760) 352-2551
690 Otay Lakes Rd
Ste 125
Chula Vista, CA 91910
Phone (760) 352-2551
1520 S Imperial Ave
El Centro, CA 92243
Phone (760) 352-2551
81812 Doctor Carreon Blvd
Ste E
Indio, CA 92201
Phone (442) 236-1498
10737 Camino Ruiz
Ste 220
San Diego, CA 92126
Phone (619) 881-4587
4840 Shawline St
San Diego, CA 92111
Phone (858) 268-7840
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Optometrist
- San Diego, CA
- NPI 1003399304
-
dba Imperial Valley Rural Health Clinic
- Rural Health Clinic/Center
- Brawley, CA
- NPI 1912662883
-
- General Practice Physician
- El Centro, CA
- NPI 1073210753
-
- Urgent Care Clinic/Center
- El Centro, CA
- NPI 1609118041
-
- Cardiac Rehabilitation Registered Nurse
- Calexico, CA
- NPI 1285494351
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641859200000",
"number": "1275684847",
"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",
"fax_number": "858-569-6596"
},
{
"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",
"fax_number": "858-569-6596"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HO",
"first_name": "HOANG",
"middle_name": "MINH",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-12",
"last_updated": "2022-01-11",
"certification_date": "2022-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "12582TPA",
"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 Jan 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.