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NPI Code Detail

MEDICARE: JOHN ANTHONY NGO NP

MEDICARE: JOHN ANTHONY NGO NP
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
1363L00000XNurse Practitioner95016181CA

General Provider Information

NPI Number : 1821688797
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN ANTHONY NGO NP
Provider Business Mailing Address
First Line : 13904 RAMHURST DR APT 9
Second Line :
City : LA MIRADA
State : CA
Zip : 90638-1728
Country : US
Telephone Number : 562-416-3895
Fax Number :
Provider Business Practice Location Address
First Line : 1350 CHESTNUT AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90813-2945
Country : US
Telephone Number : 562-599-1565
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2021
Last Update Date : 01/24/2021

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