Provider Demographics
NPI:1386696144
Name:NGO, LOAN THI HO (MD)
Entity type:Individual
Prefix:DR
First Name:LOAN
Middle Name:THI HO
Last Name:NGO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14571 MAGNOLIA ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5574
Mailing Address - Country:US
Mailing Address - Phone:714-892-1313
Mailing Address - Fax:714-891-8799
Practice Address - Street 1:14571 MAGNOLIA ST
Practice Address - Street 2:SUITE 105
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5574
Practice Address - Country:US
Practice Address - Phone:714-892-1313
Practice Address - Fax:714-891-8799
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA37821207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A378210Medicaid
CAA28462Medicare UPIN
CA00A378210Medicaid