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General NPI Number Information
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NPI Number | 1972396778
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Entity Type | Individual
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Provider Name | TANPHI NGUYEN NGO
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Gender | Male
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Dates
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Enumeration Date | 05/24/2025
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Last Update Date | 05/24/2025
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Provider Practice Location Address
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Address Line | 991 CLYDE AVE
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City | SANTA CLARA
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State | CA
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Zip | 95054-1905
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Country | US
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Telephone | 408-988-7667
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Fax |
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Provider Business Mailing Address
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Address Line | 4522 JONQUIL DR
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City | SAN JOSE
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State | CA
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Zip | 95136-2057
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Country | US
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Telephone | 714-727-8870
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 51072
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License Number State | CA
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