Basic Information
| Provider Information | |||||||||
| NPI: | 1598702177 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HO | ||||||||
| FirstName: | KALON | ||||||||
| MiddleName: | KWUN LEUNG | ||||||||
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| Credential: | M.D., M.SC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 330 BROOKLINE AVE | ||||||||
| Address2: | BIDMC, BAKER 4 | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 022155491 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176678800 | ||||||||
| FaxNumber: | 6176327460 | ||||||||
| Practice Location | |||||||||
| Address1: | 330 BROOKLINE AVE | ||||||||
| Address2: | BIDMC, BAKER 4 | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 022155491 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176678800 | ||||||||
| FaxNumber: | 6176327460 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2006 | ||||||||
| LastUpdateDate: | 11/14/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 76842 | MA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RI0011X | 76842 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
ID Information
| ID | Type | State | Issuer | Description | 3137261 | 05 | MA | MEDICAID |