Provider Demographics
NPI:1639486533
Name:NG, LIT JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:LIT
Middle Name:
Last Name:NG
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10600 EL CAMINO NUEVO
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-1508
Mailing Address - Country:US
Mailing Address - Phone:831-455-6508
Mailing Address - Fax:
Practice Address - Street 1:1339 N DAVIS RD
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93907-1988
Practice Address - Country:US
Practice Address - Phone:831-751-0414
Practice Address - Fax:831-751-0435
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-13
Last Update Date:2017-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35349183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Single Specialty
No183500000XPharmacy Service ProvidersPharmacist