Provider Demographics
NPI:1013567254
Name:NGO, TUONG AN
Entity Type:Individual
Prefix:MR
First Name:TUONG
Middle Name:AN
Last Name:NGO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 PLATTE RIVER DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-1875
Mailing Address - Country:US
Mailing Address - Phone:510-723-4328
Mailing Address - Fax:
Practice Address - Street 1:3150 PLATTE RIVER DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-1875
Practice Address - Country:US
Practice Address - Phone:510-723-4328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-19
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies