MEDICARE: JENNY NGO

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1720755788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNY NGO

Provider Business Mailing Address
First Line	:	595 BUCKINGHAM WAY STE 220
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94132-1910
Country	:	US
Telephone Number	:	415-333-0348
Fax Number	:

Provider Business Practice Location Address
First Line	:	595 BUCKINGHAM WAY STE 220
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94132-1910
Country	:	US
Telephone Number	:	415-333-0348
Fax Number	:

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

Provider Enumeration Date	:	08/26/2021
Last Update Date	:	10/12/2023

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Directions to “ JENNY NGO ” Practice Location

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