Healthcare Provider Details

I. General information

NPI: 1932858644
Provider Name (Legal Business Name): NGOC THANH NGAN MAI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2022
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12100 EUCLID ST
GARDEN GROVE CA
92840-3304
US

IV. Provider business mailing address

9872 OASIS AVE
GARDEN GROVE CA
92844-3030
US

V. Phone/Fax

Practice location:
  • Phone: 833-574-2273
  • Fax:
Mailing address:
  • Phone: 713-924-7592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number199770
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: