Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | A33989 | CA |
NPI | 1003803685 |
---|---|
Provider Name | Kim Ng |
First Address | Cerritos, CA 90703-2671 |
Second Address | Victorville, CA 92395-5808 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2005 |
Last Update Date | 12/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A33989 | LICENSE (01) | CA |