{
"Npi": {
"NPI": "1275755365",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "TAN DINH NGO MD INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "9431 EDINGER AVENUE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WESTMINSTER",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92683",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "714-839-8400",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "9431 EDINGER AVENUE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WESTMINSTER",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92683",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "714-839-8400",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/02/2007",
"LastUpdateDate": "11/30/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NGO",
"AuthorizedOfficialFirstName": "TAN",
"AuthorizedOfficialMiddleName": "DINH",
"AuthorizedOfficialTitle": "MEDICAL DIRECTOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "714-839-8400",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QH0100X",
"TaxonomyName": "Health Service Clinic/Center",
"LicenseNumber": "G75839",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}