Provider Demographics
NPI:1346746211
Name:NG, CHRISTI FONTAIN ASHLEY (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTI
Middle Name:FONTAIN ASHLEY
Last Name:NG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 BROADWAY FL 1
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5613
Mailing Address - Country:US
Mailing Address - Phone:510-752-4138
Mailing Address - Fax:
Practice Address - Street 1:3701 BROADWAY FL 1
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5613
Practice Address - Country:US
Practice Address - Phone:510-752-4138
Practice Address - Fax:720-777-7258
Is Sole Proprietor?:No
Enumeration Date:2018-03-31
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA1873322081P0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program