Provider Demographics
NPI:1588807739
Name:NGO-REYES, LINH N (MPT)
Entity Type:Individual
Prefix:
First Name:LINH
Middle Name:N
Last Name:NGO-REYES
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:LINH
Other - Middle Name:N
Other - Last Name:NGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:24630 WASHINGTON AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-6177
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10020 INDIANA AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-5477
Practice Address - Country:US
Practice Address - Phone:951-637-2320
Practice Address - Fax:951-637-2321
Is Sole Proprietor?:No
Enumeration Date:2009-04-16
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT35438225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABU986WMedicare PIN
CABU986TMedicare PIN
CABU986UMedicare PIN
CABU986VMedicare PIN
CABU986ZMedicare PIN
CABU986XMedicare PIN
CABU986YMedicare PIN