Provider Demographics
NPI:1053783704
Name:BINH T. NGO, DERMATOLOGY, P.C.
Entity type:Organization
Organization Name:BINH T. NGO, DERMATOLOGY, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BINH
Authorized Official - Middle Name:T
Authorized Official - Last Name:NGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-804-9778
Mailing Address - Street 1:34 VERSAILLES
Mailing Address - Street 2:
Mailing Address - City:NEWPORT COAST
Mailing Address - State:CA
Mailing Address - Zip Code:92657
Mailing Address - Country:US
Mailing Address - Phone:213-804-9778
Mailing Address - Fax:
Practice Address - Street 1:355 PLACENTIA AVE
Practice Address - Street 2:SUITE 308
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3311
Practice Address - Country:US
Practice Address - Phone:213-804-9778
Practice Address - Fax:888-379-3667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-21
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA89405207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty