Provider Demographics
NPI:1669748752
Name:VO, NGOC KHUONG THI
Entity type:Individual
Prefix:DR
First Name:NGOC KHUONG
Middle Name:THI
Last Name:VO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12722 RANCHERO WAY
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-3028
Mailing Address - Country:US
Mailing Address - Phone:714-873-3722
Mailing Address - Fax:
Practice Address - Street 1:12722 RANCHERO WAY
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-3028
Practice Address - Country:US
Practice Address - Phone:714-873-3722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-22
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4991213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery