Individual
ANDREW THIEN NGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1175 RENAISSANCE PKWY STE 1050, RIALTO, CA 92376-2414
(623) 486-1888
Mailing address
1175 RENAISSANCE PKWY STE 1050, RIALTO, CA 92376-2414
(909) 546-3465
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
34436-TLG
CA
152W00000X
Optometrist
3522AT
OR
Other
Enumeration date
08/13/2013
Last updated
10/29/2021
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