Provider Demographics
NPI:1528017167
Name:NGO, VINH (MD)
Entity Type:Individual
Prefix:DR
First Name:VINH
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 1:468 TEHAMA ST
Mailing Address - Street 2:#5
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-4186
Mailing Address - Country:US
Mailing Address - Phone:415-598-7633
Mailing Address - Fax:415-872-0561
Practice Address - Street 1:468 TEHAMA ST
Practice Address - Street 2:#A
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-4186
Practice Address - Country:US
Practice Address - Phone:415-598-7633
Practice Address - Fax:415-872-0561
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA81424207P00000X, 207QA0401X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A814240Medicaid
CA00A814240OtherBLUE SHIELD
I16259Medicare UPIN
CA00A814240Medicare ID - Type Unspecified