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NPI Code Detail

MEDICARE: DR. STEPHANE NGO M.D.

MEDICARE: DR. STEPHANE NGO M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianD0063898MD
22084P0800XPsychiatry PhysicianA108867CA

General Provider Information

NPI Number : 1407886765
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHANE NGO M.D.
Provider Business Mailing Address
First Line : 4855 E KINGS CANYON RD
Second Line :
City : FRESNO
State : CA
Zip : 93727-3811
Country : US
Telephone Number : 559-255-8395
Fax Number :
Provider Business Practice Location Address
First Line : 4855 E KINGS CANYON RD
Second Line :
City : FRESNO
State : CA
Zip : 93727-3811
Country : US
Telephone Number : 559-255-8395
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2006
Last Update Date : 05/27/2026

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