Provider Demographics
NPI:1346482106
Name:NGO, HUNG (DPT)
Entity Type:Individual
Prefix:MR
First Name:HUNG
Middle Name:
Last Name:NGO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9555 WARNER AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-2827
Mailing Address - Country:US
Mailing Address - Phone:562-522-3176
Mailing Address - Fax:
Practice Address - Street 1:9555 WARNER AVE
Practice Address - Street 2:SUITE A
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-2827
Practice Address - Country:US
Practice Address - Phone:562-522-3176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-25
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26455225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist