Provider Demographics
NPI:1417465436
Name:NG, TIMOTHY CHOCK HIN (PHARMD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:CHOCK HIN
Last Name:NG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11980 TELEGRAPH RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SANTA FE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:90670-6089
Mailing Address - Country:US
Mailing Address - Phone:562-347-2900
Mailing Address - Fax:
Practice Address - Street 1:11980 TELEGRAPH RD STE 100
Practice Address - Street 2:
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670-6089
Practice Address - Country:US
Practice Address - Phone:562-347-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-11
Last Update Date:2019-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77703183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist