Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | A108864 | CA |
NPI | 1013171834 |
---|---|
Provider Name | Dr. Michael Gong-Ruey Ho |
First Address | Santa Monica, CA 01803 |
Second Address | Santa Monica, CA 90403-5609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2008 |
Last Update Date | 07/06/2017 |