Basic Information
| Provider Information | |||||||||
| NPI: | 1609801877 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HO | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | MARK | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3508 | ||||||||
| Address2: | |||||||||
| City: | LITTLETON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801613508 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037222724 | ||||||||
| FaxNumber: | 3037223121 | ||||||||
| Practice Location | |||||||||
| Address1: | 850 E HARVARD AVE STE 455 | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802105079 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037222724 | ||||||||
| FaxNumber: | 3037223121 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2006 | ||||||||
| LastUpdateDate: | 01/03/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 33381 | CO | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 208D00000X | 33381 | CO | N | Allopathic & Osteopathic Physicians | General Practice |
ID Information
| ID | Type | State | Issuer | Description | 01333814 | 05 | CO | MEDICAID |