Provider Demographics
NPI:1629150859
Name:NGO, CUONG TRONG (MD)
Entity type:Individual
Prefix:
First Name:CUONG
Middle Name:TRONG
Last Name:NGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2200 S FEDERAL BLVD SUITE 1
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-5472
Mailing Address - Country:US
Mailing Address - Phone:303-935-7870
Mailing Address - Fax:303-934-2043
Practice Address - Street 1:2200 S FEDERAL BLVD SUITE 1
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80219-5472
Practice Address - Country:US
Practice Address - Phone:303-935-7870
Practice Address - Fax:303-934-2043
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO39143207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO89520858Medicaid
CO89520858Medicaid
COC447268Medicare PIN