Healthcare Provider Details

I. General information

NPI: 1720337397
Provider Name (Legal Business Name): VISAL NGA DO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2012
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1269 E ANAHEIM ST
LONG BEACH CA
90813-3709
US

IV. Provider business mailing address

PO BOX 40163
LONG BEACH CA
90806
US

V. Phone/Fax

Practice location:
  • Phone: 562-599-5300
  • Fax:
Mailing address:
  • Phone: 562-599-5300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. VISAL NGA
Title or Position: PHYSICIAN
Credential: D.O,
Phone: 562-599-5300