Healthcare Provider Details

I. General information

NPI: 1801725403
Provider Name (Legal Business Name): DALLIS NGO DO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18175 CROW CIR
CHINO HILLS CA
91709-6714
US

IV. Provider business mailing address

18175 CROW CIR
CHINO HILLS CA
91709-6714
US

V. Phone/Fax

Practice location:
  • Phone: 657-262-8352
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DALLIS NGO
Title or Position: CEO
Credential: DO
Phone: 657-262-8352