Provider Demographics
NPI:1629729827
Name:TING, THOMAS (DPT)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:TING
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28412 RANCHO CRISTIANO
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-7427
Mailing Address - Country:US
Mailing Address - Phone:714-598-6981
Mailing Address - Fax:
Practice Address - Street 1:28412 RANCHO CRISTIANO
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-7427
Practice Address - Country:US
Practice Address - Phone:714-598-6981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT300765208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation