Provider Demographics
NPI:1154373538
Name:NGAW, LILLIAN WINN KHO (MD)
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:WINN KHO
Last Name:NGAW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:WINN
Other - Middle Name:KHO
Other - Last Name:NGAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:65 N MADISON AVE STE 709
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2046
Mailing Address - Country:US
Mailing Address - Phone:626-792-4185
Mailing Address - Fax:626-792-7358
Practice Address - Street 1:65 N MADISON AVE STE 709
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2046
Practice Address - Country:US
Practice Address - Phone:626-792-4185
Practice Address - Fax:626-792-7358
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50290207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A502900Medicaid
F85209Medicare UPIN
CAWA50290BMedicare ID - Type Unspecified