Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | A130461 | CA |
Y | 111NI0900X | Internist | A130461 | CA |
NPI | 1003187766 |
---|---|
Provider Name | Jie Ling |
First Address | San Mateo, CA 94401-1840 |
Second Address | Burlingame, CA 94010-3115 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2012 |
Last Update Date | 19/11/2015 |