Provider Demographics
NPI:1083793947
Name:ING, CLARENCE SINN FOOK (MD)
Entity Type:Individual
Prefix:DR
First Name:CLARENCE
Middle Name:SINN FOOK
Last Name:ING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 486
Mailing Address - Street 2:
Mailing Address - City:WEIMAR
Mailing Address - State:CA
Mailing Address - Zip Code:95736-0486
Mailing Address - Country:US
Mailing Address - Phone:530-637-4111
Mailing Address - Fax:530-637-4443
Practice Address - Street 1:20601 WEST PAOLI LANE
Practice Address - Street 2:
Practice Address - City:WEIMAR
Practice Address - State:CA
Practice Address - Zip Code:95736-0486
Practice Address - Country:US
Practice Address - Phone:530-637-4111
Practice Address - Fax:530-637-4443
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA21157207W00000X, 2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Not Answered2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F14864Medicare UPIN
CA00A211570Medicare PIN