Provider Demographics
NPI:1497763536
Name:NGO, HIEP Q (MD)
Entity Type:Individual
Prefix:
First Name:HIEP
Middle Name:Q
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 1:625 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-3785
Mailing Address - Country:US
Mailing Address - Phone:408-278-3003
Mailing Address - Fax:
Practice Address - Street 1:400 RACE ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-3518
Practice Address - Country:US
Practice Address - Phone:408-278-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA791592084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA246634OtherINTERPLAN
CA4354274OtherCIGNA
CA1805685OtherGREAT WEST
CA5636001OtherFIRST HEALTH
CA2457645OtherUNITED HEALTHCARE
CA7277606OtherAETNA
CA000810713548OtherPHCS
CAMCMG351800OtherWESTERN HEALTH ADVANTAGE
CA00A791590Medicaid
CA106663OtherHEALTH NET
CA90142783OtherPACIFICARE
CAA79159OtherBLUE CROSS
CA5636001OtherFIRST HEALTH
CA00A791590Medicaid