Provider Demographics
NPI:1013205228
Name:NGO, CHRISTOPHER (OD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:NGO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20387 GILLICK WAY
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-4412
Mailing Address - Country:US
Mailing Address - Phone:408-506-1539
Mailing Address - Fax:
Practice Address - Street 1:1080 S WHITE RD
Practice Address - Street 2:A
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95127-3821
Practice Address - Country:US
Practice Address - Phone:408-272-3002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14536 TLG152W00000X
NV705152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist