Individual
DIEM L NGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
26520 CACTUS AVE, MORENO VALLEY, CA 92555-3927
(951) 486-4000
Mailing address
2813 S MAIN ST, CORONA, CA 92882-5942
(951) 272-5445
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1538542287
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/30/2015
Last updated
01/14/2024
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