Active NPI
Kim Ngo, PA-C
- Physician Assistant
- Beverly Hills, CA
National Provider Identifier
1922317486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 21319
- Practice address
- 433 N Camden Dr FL 6
Beverly Hills, CA 90210-4416 - Phone
- (855) 254-1434
- NPI assigned
- Oct 1, 2010
- Reactivated
- Nov 4, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | 21319 | CA | Primary |
Addresses
Primary practice location
433 N Camden Dr FL 6
Beverly Hills, CA 90210-4416
Mailing address
433 N Camden Dr FL 6
Beverly Hills, CA 90210-4416
Phone (855) 254-1434
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21319 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604448000000",
"number": "1922317486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "433 N CAMDEN DR FL 6",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902104416",
"telephone_number": "855-254-1434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "433 N CAMDEN DR FL 6",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902104416",
"telephone_number": "855-254-1434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGO",
"first_name": "KIM",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-10-01",
"last_updated": "2020-11-04",
"certification_date": "2020-11-04",
"deactivation_date": "2020-10-23",
"reactivation_date": "2020-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "21319",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beverly Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.