Doctor Name: | TRI MINH NGO |
NPI Number: | 1073804837 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | |
Business Practice Address: | 11234 Anderson St Graduate Medical Education Office Csp 21005 Loma Linda, CA - 923542804 |
Business Phone Number: | 9095587814 |
Business Fax Number: | |
Mailing Address: | 14792 Adams St Apt B, MIDWAY CITY |
State: | CA |
Postal Code: | 926551238 |
Phone Number: | 7148946609 |
Fax Number: | |
NPI Enumeration Date: | 04/28/2011 |
NPI Last Update Date: | 06/07/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |