Provider Demographics
NPI:1073312492
Name:NGO, JONATHAN LINGAD (PT, DPT)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:LINGAD
Last Name:NGO
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 PARADISE HILLS RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92114-7843
Mailing Address - Country:US
Mailing Address - Phone:619-519-4886
Mailing Address - Fax:
Practice Address - Street 1:386 E H ST
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-7485
Practice Address - Country:US
Practice Address - Phone:619-482-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA307656225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist