Provider Demographics
NPI:1073035028
Name:NGO, RYAN TUAN QUY (OD)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:TUAN QUY
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 1:57 W 86TH ST APT 3A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3661
Mailing Address - Country:US
Mailing Address - Phone:408-499-7005
Mailing Address - Fax:
Practice Address - Street 1:711 VAN NESS AVE STE 300
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-3286
Practice Address - Country:US
Practice Address - Phone:415-567-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008663152W00000X
CA37458TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist