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General NPI Number Information
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NPI Number | 1164629705
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Entity Type | Individual
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Provider Name | CHAU T.M. NGO D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 06/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3736 S BRISTOL ST
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City | SANTA ANA
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State | CA
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Zip | 92704-7304
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Country | US
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Telephone | 714-751-5538
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Fax |
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Provider Business Mailing Address
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Address Line | 3220 W 168TH ST
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City | TORRANCE
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State | CA
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Zip | 90504-1743
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 55780
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License Number State | CA
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