Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | NM287 | NM |
Y | 222Z00000X | Podiatrist | NM287 | NM |
NPI | 1023124203 |
---|---|
Provider Name | Andy Ngoc Ho |
First Address | Albuquerque, NM 87109-3369 |
Second Address | Albuquerque, NM 87109-3369 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 20/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
213E00000X | (05) | NM |
NM005491 | BCBSNM (01) | |
P00206089 | RAIL ROAD (01) | |
U94451 | (02) |