Provider Demographics
NPI:1558484618
Name:NG, DAVID G (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:G
Last Name:NG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:150 N ROBERTSON BLVD
Mailing Address - Street 2:STE 150
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2171
Mailing Address - Country:US
Mailing Address - Phone:310-424-5480
Mailing Address - Fax:310-652-4053
Practice Address - Street 1:150 N ROBERTSON BLVD
Practice Address - Street 2:STE 150
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2171
Practice Address - Country:US
Practice Address - Phone:310-424-5480
Practice Address - Fax:310-652-4053
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA83139207RP1001X, 208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA11854280OtherCAQH
CA1558484618Medicaid
CA00A831390OtherBLUE SHIELD PPO
CAA83139OtherMEDICAL LICENSE
CAA83139OtherMEDICAL LICENSE
CABN8318532OtherDEA CERTIFICATE
CA1558484618Medicaid