Provider Demographics
NPI:1144230152
Name:BAGUIO NGO, EMELIE (MD)
Entity Type:Individual
Prefix:DR
First Name:EMELIE
Middle Name:
Last Name:BAGUIO NGO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EMELIE
Other - Middle Name:TRINIDAD
Other - Last Name:BAGUIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:26104 SINGER PL
Mailing Address - Street 2:
Mailing Address - City:STEVENSON RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91381-1113
Mailing Address - Country:US
Mailing Address - Phone:661-373-4757
Mailing Address - Fax:
Practice Address - Street 1:43112 15TH ST W
Practice Address - Street 2:KAISER PERMANENTE
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-6219
Practice Address - Country:US
Practice Address - Phone:888-778-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2021-12-14
Deactivation Date:2006-08-22
Deactivation Code:
Reactivation Date:2006-09-15
Provider Licenses
StateLicense IDTaxonomies
CAA68703207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A687030Medicaid
CAWA68703DMedicare ID - Type Unspecified
CA00A687030Medicaid