Provider Demographics
NPI:1720309610
Name:VO, NGOCTRAM THI (DO)
Entity Type:Individual
Prefix:DR
First Name:NGOCTRAM
Middle Name:THI
Last Name:VO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:STACI
Other - Middle Name:THI
Other - Last Name:VO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:17215 STUDEBAKER RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-2548
Mailing Address - Country:US
Mailing Address - Phone:562-924-7307
Mailing Address - Fax:562-860-9398
Practice Address - Street 1:17215 STUDEBAKER RD
Practice Address - Street 2:SUITE 300
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-2548
Practice Address - Country:US
Practice Address - Phone:562-924-7307
Practice Address - Fax:562-860-9398
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-15
Last Update Date:2014-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A111852084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry