Provider Demographics
NPI:1700027216
Name:AN NGOC TO MD INC
Entity Type:Organization
Organization Name:AN NGOC TO MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AN
Authorized Official - Middle Name:N
Authorized Official - Last Name:TO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-279-1180
Mailing Address - Street 1:87 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-5423
Mailing Address - Country:US
Mailing Address - Phone:408-279-1180
Mailing Address - Fax:408-279-6745
Practice Address - Street 1:87 N 6TH ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-5423
Practice Address - Country:US
Practice Address - Phone:408-279-1180
Practice Address - Fax:408-279-6745
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AN NGOC TO MD INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-12
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA363990207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4805916Medicaid
CAA28072OtherMEDICARE UPIN