Provider Demographics
NPI:1821308339
Name:NGO, RICKY (DC)
Entity Type:Individual
Prefix:
First Name:RICKY
Middle Name:
Last Name:NGO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2191
Mailing Address - Street 2:
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792-8191
Mailing Address - Country:US
Mailing Address - Phone:808-425-2473
Mailing Address - Fax:808-452-0224
Practice Address - Street 1:87-2070 FARRINGTON HWY # B4
Practice Address - Street 2:
Practice Address - City:WAIANAE
Practice Address - State:HI
Practice Address - Zip Code:96792-3757
Practice Address - Country:US
Practice Address - Phone:808-425-2473
Practice Address - Fax:808-452-0224
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-18
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010012550111N00000X
HI1344111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor