Provider Demographics
NPI:1407886765
Name:NGO, STEPHANE (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANE
Middle Name:
Last Name:NGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N COURT ST
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-4918
Mailing Address - Country:US
Mailing Address - Phone:559-627-2046
Mailing Address - Fax:559-627-9079
Practice Address - Street 1:201 N COURT ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-4918
Practice Address - Country:US
Practice Address - Phone:559-627-2046
Practice Address - Fax:559-627-9079
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00638982084P0800X
CAA1088672084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry