MEDICARE: KATHERINE NGHIA NGO PHARMD

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	183500000X	Pharmacist	69022	CA

General Provider Information

NPI Number	:	1316389554
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE NGHIA NGO PHARMD

Provider Business Mailing Address
First Line	:	1041 N BAXTER ST
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92805-1605
Country	:	US
Telephone Number	:	714-776-5646
Fax Number	:

Provider Business Practice Location Address
First Line	:	1041 N BAXTER ST
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92805-1605
Country	:	US
Telephone Number	:	714-776-5646
Fax Number	:

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

Provider Enumeration Date	:	07/29/2013
Last Update Date	:	07/29/2013

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