Provider Demographics
NPI:1326190539
Name:PING, ANDREW CLOUDY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:CLOUDY
Last Name:PING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 PROSPECT ST
Mailing Address - Street 2:# 19
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-4246
Mailing Address - Country:US
Mailing Address - Phone:858-551-8030
Mailing Address - Fax:
Practice Address - Street 1:4020 5TH AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2106
Practice Address - Country:US
Practice Address - Phone:619-260-7022
Practice Address - Fax:619-260-7305
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45213207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine