Provider Demographics
NPI:1134706757
Name:NGO, THONG ANH (DO)
Entity type:Individual
Prefix:
First Name:THONG
Middle Name:ANH
Last Name:NGO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5155 KATELLA AVE APT 405
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-2965
Mailing Address - Country:US
Mailing Address - Phone:714-251-8108
Mailing Address - Fax:
Practice Address - Street 1:250 E RINCON ST STE 106
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-1363
Practice Address - Country:US
Practice Address - Phone:951-339-8459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-28
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A22327207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine