Healthcare Provider Details

I. General information

NPI: 1124245824
Provider Name (Legal Business Name): ALEX W NGO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8403 FALLBROOK AVE
WEST HILLS CA
91304-3226
US

IV. Provider business mailing address

8403 FALLBROOK AVE
WEST HILLS CA
91304-3226
US

V. Phone/Fax

Practice location:
  • Phone: 818-737-6119
  • Fax: 818-737-6216
Mailing address:
  • Phone: 818-737-6119
  • Fax: 818-737-6216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License NumberA42439
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: