Active NPI
John Ho, MD
- Internal Medicine Physician
- Fountain Valley, CA
National Provider Identifier
1841267366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- G145781
- Practice address
- 17360 Brookhurst St
Attn: Credentialing Department
Fountain Valley, CA 92708-3720 - Phone
- (714) 377-2900
- NPI assigned
- Mar 2, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | G145781 | CA | Primary |
| Internal Medicine Physician | 207R00000X | 37803 | CO |
Addresses
Primary practice location
17360 Brookhurst St
Attn: Credentialing Department
Fountain Valley, CA 92708-3720
Mailing address
17360 Brookhurst St
Attn: Credentialing Department
Fountain Valley, CA 92708-3720
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 59054875 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G145781 | CA | MD | Internal Medicine Physician |
| 37803 | CO | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorialcare Medical Foundation | Internal Medicine | Current | Accepting new patients |
Locations
722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300
17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592
15464 Goldenwest St
Westminster, CA 92683
Phone (714) 891-9008
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492560000000",
"number": "1841267366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17360 BROOKHURST ST",
"address_2": "ATTN: CREDENTIALING DEPARTMENT",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927083720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17360 BROOKHURST ST",
"address_2": "ATTN: CREDENTIALING DEPARTMENT",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927083720",
"telephone_number": "714-377-2900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HO",
"first_name": "JOHN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-02",
"last_updated": "2017-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "G145781",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CO",
"license": "37803",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "59054875",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fountain Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; 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.