Individual provider Active NPI

Thanh Ngo, D.O

  • Family Medicine Physician
  • Colton, CA
National Provider Identifier
1124381231
Registry record updated Mar 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A13190 Issued in CA
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

Updated by the provider on Mar 11, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151103002862 CA Practitioner - Family Practice 8820308844 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
13190CAMDClinical Social Worker
20A13190CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Bernardino CurrentSince Dec 17, 2023 Accepting new patients
County of San Bernardino CurrentSince Dec 17, 2023 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.

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

Verify at the official NPI Registry.