Basic Information
| Provider Information | |||||||||
| NPI: | 1649525437 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | NGO | ||||||||
| FirstName: | ANNA | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 48 | ||||||||
| Address2: | |||||||||
| City: | MILLBRAE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940300048 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6265600961 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2574 SAN BRUNO AVE | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941341505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4153919686 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2012 | ||||||||
| LastUpdateDate: | 02/14/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | PA22335 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.