Active NPI
Thanh Ngo, D.O
- Family Medicine Physician
- Colton, CA
National Provider Identifier
1124381231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20A13190
- Practice address
- 400 N Pepper Ave
Colton, CA 92324-1801 - Phone
- (909) 580-1000
- NPI assigned
- Jun 22, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20A13190 | CA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
400 N Pepper Ave
Colton, CA 92324-1801
Mailing address
400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-3366
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13190 | CA | MD | Clinical Social Worker |
| 20A13190 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of San Bernardino | Current | Accepting new patients | |
| County of San Bernardino | Current | Accepting new patients | |
| County of San Bernardino | Current | Accepting new patients |
Locations
400 N Pepper Ave
Ste 301
Colton, CA 92324
Phone (909) 580-3366
400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1800
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- San Bernardino, CA
- NPI 1164467023
-
- General Acute Care Hospital
- Colton, CA
- NPI 1114091576
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Apple Valley, CA
- NPI 1346950904
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426032000000",
"number": "1124381231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 N PEPPER AVE",
"city": "COLTON",
"state": "CA",
"postal_code": "923241801",
"telephone_number": "909-580-3366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 N PEPPER AVE",
"city": "COLTON",
"state": "CA",
"postal_code": "923241801",
"telephone_number": "909-580-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGO",
"first_name": "THANH",
"credential": "D.O",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-22",
"last_updated": "2015-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "20A13190",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Colton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.