Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175L00000X | Homeopath | ||
Y | 225700000X | Massage Therapist |
NPI | 1851583801 |
---|---|
Provider Name | Ms. Gloria Ng |
First Address | Oakland, CA 94608-1403 |
Second Address | Oakland, CA 94608-1403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2007 |
Last Update Date | 14/08/2007 |