Provider Demographics
NPI:1063122893
Name:DR TUNG NGO, INC
Entity type:Organization
Organization Name:DR TUNG NGO, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TUNG
Authorized Official - Middle Name:H
Authorized Official - Last Name:NGO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:949-566-1022
Mailing Address - Street 1:5421 W HENDERSON PL
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-1037
Mailing Address - Country:US
Mailing Address - Phone:949-566-1022
Mailing Address - Fax:478-313-5538
Practice Address - Street 1:11100 WARNER AVE STE 158
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-7510
Practice Address - Country:US
Practice Address - Phone:714-279-0010
Practice Address - Fax:478-313-5538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-02
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty