Provider Demographics
NPI:1609904085
Name:DAI, JING (MD)
Entity Type:Individual
Prefix:DR
First Name:JING
Middle Name:
Last Name:DAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2299 MOWRY AVE
Mailing Address - Street 2:3A
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1621
Mailing Address - Country:US
Mailing Address - Phone:510-794-1411
Mailing Address - Fax:510-794-1570
Practice Address - Street 1:2299 MOWRY AVE
Practice Address - Street 2:3A
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1621
Practice Address - Country:US
Practice Address - Phone:510-794-1411
Practice Address - Fax:510-794-1570
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA88518207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology