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General NPI Number Information
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NPI Number | 1821688797
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Entity Type | Individual
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Provider Name | JOHN ANTHONY NGO NP
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Gender | Male
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Dates
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Enumeration Date | 01/24/2021
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Last Update Date | 01/24/2021
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Provider Practice Location Address
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Address Line | 1350 CHESTNUT AVE
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City | LONG BEACH
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State | CA
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Zip | 90813-2945
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Country | US
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Telephone | 562-599-1565
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Fax |
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Provider Business Mailing Address
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Address Line | 13904 RAMHURST DR APT 9
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City | LA MIRADA
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State | CA
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Zip | 90638-1728
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Country | US
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Telephone | 562-416-3895
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95016181
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License Number State | CA
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