Individual provider Active NPI

Anh T Ngo, RPH

  • Pharmacist
  • South Lake Tahoe, CA
National Provider Identifier
1316580376
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH79764 Issued in CA
Practice address
1043 Emerald Bay Rd
South Lake Tahoe, CA 96150-6210
Phone
(916) 297-2040
NPI assigned
Oct 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH79764 CA Primary

Addresses

Primary practice location

1043 Emerald Bay Rd
South Lake Tahoe, CA 96150-6210

Mailing address

2187 Lake Tahoe Blvd Apt 15
South Lake Tahoe, CA 96150-6465
Phone (310) 947-4912

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL anhngo001@gmail.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RPH79764CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Longs Drug Stores California LLC PastSince Oct 27, 2019 Accepting new patients
Longs Drug Store California LLC PastSince Oct 27, 2019 Accepting new patients

Organizations & group practices 2

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": "1571702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1316580376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2187 LAKE TAHOE BLVD APT 15",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961506465",
            "telephone_number": "310-947-4912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1043 EMERALD BAY RD",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961506210",
            "telephone_number": "916-297-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGO",
        "first_name": "ANH",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-22",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH79764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "anhngo001@gmail.com",
            "affiliation": "N",
            "endpointDescription": "anhngo001@gmail.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "South Lake Tahoe",
            "address_1": "1043 Emerald Bay Rd",
            "city": "South Lake Tahoe",
            "state": "CA",
            "country_code": "US",
            "postal_code": "961506210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in South Lake Tahoe, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.