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General NPI Number Information
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NPI Number | 1063122893
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Entity Type | Organization
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Legal Business Name | DR TUNG NGO, INC
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Dates
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Enumeration Date | 12/02/2022
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Last Update Date | 01/05/2023
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Provider Practice Location Address
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Address Line | 11100 WARNER AVE STE 158
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-7510
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Country | US
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Telephone | 714-279-0010
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Fax | 478-313-5538
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Provider Business Mailing Address
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Address Line | 5421 W HENDERSON PL
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City | SANTA ANA
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State | CA
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Zip | 92704-1037
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Country | US
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Telephone | 949-566-1022
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Fax | 478-313-5538
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Authorized Official
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Title or Position | OWNER
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Name | DR. TUNG H NGO
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Credential | DO
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Telephone | 949-566-1022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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