MEDICARE: DALLIS NGO DO INC

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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician
2	207RP1001X	Pulmonary Disease Physician

General Provider Information

NPI Number	:	1801725403
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DALLIS NGO DO INC

Provider Business Mailing Address
First Line	:	18175 CROW CIR
Second Line	:
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-6714
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18175 CROW CIR
Second Line	:
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-6714
Country	:	US
Telephone Number	:	657-262-8352
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. DALLIS NGO
Credential	:	DO
Telephone Number	:	408-889-3200

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/25/2026

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Directions to “DALLIS NGO DO INC ” Practice Location

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