Provider Demographics
NPI:1841442126
Name:NGO, TAMMY (LAC)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:NGO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2617 NORTHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95132-1035
Mailing Address - Country:US
Mailing Address - Phone:408-263-3217
Mailing Address - Fax:
Practice Address - Street 1:485 LOS COCHES ST
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-5422
Practice Address - Country:US
Practice Address - Phone:408-946-9332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11634171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist