Organization Active NPI

Huong-Anh Ngo Long, M.D., Inc.

  • Physical Medicine & Rehabilitation Physician
  • San Pedro, CA
National Provider Identifier
1972709558
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
G62453 Issued in CA
Legal business name
HUONG-ANH NGO LONG, M.D., INC.
Practice address
1300 W 7TH St
San Pedro, CA 90732-3505
Phone
(310) 514-5208
Fax
(310) 514-5374
NPI assigned
Jun 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Huong-Anh Ngo Long, M.D.NPI 1982610218
Title
Owner
Phone
(310) 514-5208

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X G62453 CA Primary

Addresses

Primary practice location

1300 W 7TH St
San Pedro, CA 90732-3505

Mailing address

1621 W 25TH St
#161
San Pedro, CA 90732-4301
Phone (310) 514-5208

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050606001248 CA Part B Supplier - Clinic/Group Practice 0547203085 Receives reassigned benefits from 2 practitioners
Practice locations: San Pedro, CA; Torrance, CA

National Provider Directory

National Provider Directory

Locations

1300 W 7th St
Fl 3
San Pedro, CA 90732
Phone (310) 514-5208

1360 W 6th St
Ste 160
San Pedro, CA 90732
Phone (310) 514-5377

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972709558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 W 25TH ST",
            "address_2": "#161",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907324301",
            "telephone_number": "310-514-5208",
            "fax_number": "310-514-5374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W 7TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907323505",
            "telephone_number": "310-514-5208",
            "fax_number": "310-514-5374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUONG-ANH NGO LONG, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "HUONG-ANH",
        "authorized_official_middle_name": "NGO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-514-5208",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "G62453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pedro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.