Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 14536 TLG | CA |
N | 152W00000X | Optometrist | 705 | NV |
NPI | 1013205228 |
---|---|
Provider Name | Christopher Ngo |
First Address | Cupertino, CA 95014-4412 |
Second Address | San Jose, CA 95127-3821 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2011 |
Last Update Date | 22/12/2021 |