Provider Demographics
NPI:1053711481
Name:NG, EDWARD
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:NG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 N MADISON AVE
Mailing Address - Street 2:APT. 310
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-4473
Mailing Address - Country:US
Mailing Address - Phone:626-371-3652
Mailing Address - Fax:
Practice Address - Street 1:261 N MADISON AVE
Practice Address - Street 2:APT. 310
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-4473
Practice Address - Country:US
Practice Address - Phone:626-371-3652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program