Provider Demographics
NPI:1508093444
Name:NGOON, ERIC SWE LOON (LVN)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:SWE LOON
Last Name:NGOON
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1871 47TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-3917
Mailing Address - Country:US
Mailing Address - Phone:415-664-3971
Mailing Address - Fax:
Practice Address - Street 1:121 CSH A CO.
Practice Address - Street 2:BOX# 838
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96205
Practice Address - Country:US
Practice Address - Phone:315-737-3209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201220164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse