Provider Demographics
NPI:1174987549
Name:MO, LIHONG (MD)
Entity type:Individual
Prefix:DR
First Name:LIHONG
Middle Name:
Last Name:MO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 PACCHETTI WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-1237
Mailing Address - Country:US
Mailing Address - Phone:919-428-6093
Mailing Address - Fax:
Practice Address - Street 1:4860 Y ST STE 2500
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2307
Practice Address - Country:US
Practice Address - Phone:916-734-6938
Practice Address - Fax:916-734-6938
Is Sole Proprietor?:No
Enumeration Date:2016-04-11
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA158729207V00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program