Provider Demographics
NPI:1710046784
Name:HO, SHIU-BONG LAWRENCE (DPT, OCS)
Entity type:Individual
Prefix:DR
First Name:SHIU-BONG
Middle Name:LAWRENCE
Last Name:HO
Suffix:
Gender:M
Credentials:DPT, OCS
Other - Prefix:
Other - First Name:LAWRENCE
Other - Middle Name:
Other - Last Name:HO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT, OCS
Mailing Address - Street 1:18344 CLARK ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3580
Mailing Address - Country:US
Mailing Address - Phone:818-996-8386
Mailing Address - Fax:818-996-8979
Practice Address - Street 1:18344 CLARK ST
Practice Address - Street 2:SUITE 208
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3580
Practice Address - Country:US
Practice Address - Phone:818-996-8386
Practice Address - Fax:818-996-8979
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT89592251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT8959AMedicare ID - Type UnspecifiedPHYSICAL THERAPY