Active NPI
Anthony Nguyen Ngo, PA-C
- Physician Assistant
- Redlands, CA
National Provider Identifier
1912308222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 51902
- Practice address
- 10408 Industrial Cir
Redlands, CA 92374-4548 - Phone
- (909) 796-7803
- NPI assigned
- Sep 6, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 51902 | CA | Primary |
Addresses
Primary practice location
10408 Industrial Cir
Redlands, CA 92374-4548
Mailing address
2613 Curtis Ave Apt C
Redondo Beach, CA 90278-2236
Phone (310) 407-9602
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51902 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438646400000",
"number": "1912308222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2613 CURTIS AVE APT C",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "902782236",
"telephone_number": "310-407-9602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10408 INDUSTRIAL CIR",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923744548",
"telephone_number": "909-796-7803"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGO",
"first_name": "ANTHONY",
"middle_name": "NGUYEN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-09-06",
"last_updated": "2015-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "51902",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redlands, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.