Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 45300 | CA |
NPI | 1003944638 |
---|---|
Provider Name | Thanh Chi Ngo |
First Address | Westminster, CA 92683 |
Second Address | Westminster, CA 92683 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
45300 | (05) | CA |