Provider Demographics
NPI:1174605331
Name:NGO, DOAN C (DC)
Entity type:Individual
Prefix:MR
First Name:DOAN
Middle Name:C
Last Name:NGO
Suffix:
Gender:M
Credentials:DC
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Other - First Name:
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Mailing Address - Street 1:13120 BROOKHURST ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-5501
Mailing Address - Country:US
Mailing Address - Phone:714-590-1710
Mailing Address - Fax:714-590-1451
Practice Address - Street 1:13120 BROOKHURST ST
Practice Address - Street 2:SUITE A
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-5501
Practice Address - Country:US
Practice Address - Phone:714-590-1710
Practice Address - Fax:714-590-1451
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2015-04-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CADC27349111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00073063Medicare PIN