Basic Information
Provider Information
NPI: 1972198729
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HO
FirstName: CAROL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PHARMD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 447 ORIZABA AVE
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941322824
CountryCode: US
TelephoneNumber: 4158236798
FaxNumber:  
Practice Location
Address1: 845 JACKSON ST
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941334899
CountryCode: US
TelephoneNumber: 4159822400
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/03/2021
LastUpdateDate: 03/03/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/03/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X76673CAY Pharmacy Service ProvidersPharmacist 

No ID Information.


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