Provider Demographics
NPI:1467957167
Name:ING, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:ING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 BRADEN AVE APT 77
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-0655
Mailing Address - Country:US
Mailing Address - Phone:213-239-3187
Mailing Address - Fax:
Practice Address - Street 1:401 PARADISE RD STE E
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95351-3163
Practice Address - Country:US
Practice Address - Phone:209-558-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program