MEDICARE: DR. CUONG VIET NGO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	G75199	CA

General Provider Information

NPI Number	:	1285760850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CUONG VIET NGO MD

Provider Business Mailing Address
First Line	:	2142 W CHERRYWOOD LN
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92804-2490
Country	:	US
Telephone Number	:	714-758-1837
Fax Number	:

Provider Business Practice Location Address
First Line	:	250 HOSPITAL CIR
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-3953
Country	:	US
Telephone Number	:	714-899-3498
Fax Number	:	714-899-3493

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	07/08/2007

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