Provider Demographics
NPI:1326101593
Name:NG, DAVID CHANG (DPM)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CHANG
Last Name:NG
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:13960 BLACK ROCK CIR
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-5025
Mailing Address - Country:US
Mailing Address - Phone:805-497-7822
Mailing Address - Fax:805-293-6768
Practice Address - Street 1:123 HODENCAMP RD STE 101
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-5833
Practice Address - Country:US
Practice Address - Phone:805-497-7822
Practice Address - Fax:805-293-6768
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2023-01-09
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Provider Licenses
StateLicense IDTaxonomies
CAE4111213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU70657Medicare UPIN