Provider Demographics
NPI:1891075990
Name:NGO, CHRISTINE N (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:N
Last Name:NGO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:325 UNION AVE
Mailing Address - Street 2:APT 264
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-4253
Mailing Address - Country:US
Mailing Address - Phone:408-887-4993
Mailing Address - Fax:
Practice Address - Street 1:3561 EL CAMINO REAL
Practice Address - Street 2:SUITE 40
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-2101
Practice Address - Country:US
Practice Address - Phone:408-984-2020
Practice Address - Fax:408-984-2010
Is Sole Proprietor?:No
Enumeration Date:2011-08-19
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14223TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist