MEDICARE: RENEE LIM NGO MD

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
1	2084P0800X	Psychiatry Physician	10905	NV
2	2084P0805X	Geriatric Psychiatry Physician	10905	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	432058646	OTHER		PBH
2	432058646	OTHER		TRICARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	CS12498	OTHER	NV	CS
5	332338	OTHER		MHN
6	432058646	OTHER		UBH
7	1619902	OTHER		CIGNA
8	432058646	OTHER		MEDIVERSAL
9	NV1580	OTHER		BCBS
10	21250983138	OTHER		BEECHSTREET
11	727662000	OTHER		MAGELLAN
12	2202522	OTHER		CBH
13	432058646	OTHER		TEACHERS HEALTH
14	432058646	OTHER		PACIFICARE
15	9374117	OTHER		PHCS
16	NV1580	OTHER		HBI

General Provider Information

NPI Number	:	1902889264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENEE LIM NGO MD

Provider Business Mailing Address
First Line	:	PO BOX 778207
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89077-8207
Country	:	US
Telephone Number	:	702-855-0748
Fax Number	:	702-436-8088

Provider Business Practice Location Address
First Line	:	3680 E SUNSET RD STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-7219
Country	:	US
Telephone Number	:	702-855-0748
Fax Number	:	702-436-8088

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2005
Last Update Date	:	03/07/2023

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