Provider Demographics
NPI:1013065473
Name:NGON HOANG DINH DO A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:NGON HOANG DINH DO A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NGON
Authorized Official - Middle Name:HOANG
Authorized Official - Last Name:DINH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:408-279-6700
Mailing Address - Street 1:PO BOX 3674
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95156-3674
Mailing Address - Country:US
Mailing Address - Phone:408-279-6700
Mailing Address - Fax:408-279-6760
Practice Address - Street 1:200 JOSE FIGUERES AVE STE 290
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1587
Practice Address - Country:US
Practice Address - Phone:408-251-9700
Practice Address - Fax:408-251-9799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A6290207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & NeckGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX62900Medicaid
CAF66059Medicare UPIN