Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | A34849 | CA |
N | 2080A0000X | Adolescent Medicine | A34849 | CA |
NPI | 1295911915 |
---|---|
Provider Name | Madeleine Nguyen Ngo |
First Address | Hacienda Hts, CA 91745-6840 |
Second Address | Hacienda Hts, CA 91745-6840 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2008 |
Last Update Date | 11/01/2008 |