Healthcare Provider Details

I. General information

NPI: 1528017167
Provider Name (Legal Business Name): VINH NGO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 05/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

468 TEHAMA ST #A
SAN FRANCISCO CA
94103-4186
US

IV. Provider business mailing address

468 TEHAMA ST #5
SAN FRANCISCO CA
94103-4186
US

V. Phone/Fax

Practice location:
  • Phone: 415-598-7633
  • Fax: 415-872-0561
Mailing address:
  • Phone: 415-598-7633
  • Fax: 415-872-0561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA81424
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberA81424
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberA81424
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: