Provider Demographics
NPI:1578268587
Name:ONG, MENG-KHIANG GABRIEL
Entity Type:Individual
Prefix:
First Name:MENG-KHIANG
Middle Name:GABRIEL
Last Name:ONG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:MENG-KHIANG
Other - Middle Name:GABRIEL
Other - Last Name:ONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:17234 VALLEY BOULEVARD, BUILDING A
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335-6720
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17234 VALLEY BOULEVARD, BUILDING A
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-6720
Practice Address - Country:US
Practice Address - Phone:833-574-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-31
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program