Individual provider Active NPI

Lennie Thanh Ho Ngo, PA-C

  • Surgical Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1689166787
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA55638 Issued in CA
Practice address
1225 Wilshire Blvd
Los Angeles, CA 90017
Phone
(213) 977-2121
NPI assigned
Jun 4, 2018
Last updated
Aug 22, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA55638 CA Primary

Addresses

Primary practice location

1225 Wilshire Blvd
Los Angeles, CA 90017

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (213) 977-2121

Other practice location 1

650 Liberation Way
Fullerton, CA 92832-2649
Phone (156) 230-3345

Other names 1

  • Thanh Ho Ngo Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180827002962 CA Practitioner - Physician Assistant 2062761877 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA55638CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Apr 4, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince Apr 4, 2022 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jul 1, 2018 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jul 1, 2018 Accepting new patients

Locations

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3340

1812 Verdugo Blvd
Glendale, CA 91208
Phone (818) 246-8000

1225 Wilshire Blvd
Los Angeles, CA 90017
Phone (213) 482-2741

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5860

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1689166787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "213-977-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90017",
            "telephone_number": "213-977-2121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 Liberation Way",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928322649",
            "country_code": "US",
            "telephone_number": "156-230-3345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HO NGO",
        "first_name": "LENNIE",
        "middle_name": "THANH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-04",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA55638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THANH",
            "last_name": "HO NGO",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.