Healthcare Provider Details

I. General information

NPI: 1174987549
Provider Name (Legal Business Name): LIHONG MO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2016
Last Update Date: 07/17/2020
Certification Date: 07/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4860 Y ST STE 2500
SACRAMENTO CA
95817-2307
US

IV. Provider business mailing address

142 PACCHETTI WAY
MOUNTAIN VIEW CA
94040-1237
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-6938
  • Fax: 916-734-6938
Mailing address:
  • Phone: 919-428-6093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA158729
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: