Provider Demographics
NPI:1659479236
Name:DR. ROBERT Y. K. ING, INC.
Entity Type:Organization
Organization Name:DR. ROBERT Y. K. ING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:Y K
Authorized Official - Last Name:ING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-698-1168
Mailing Address - Street 1:24703 MONROE AVE.
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562
Mailing Address - Country:US
Mailing Address - Phone:951-698-1168
Mailing Address - Fax:951-698-0768
Practice Address - Street 1:24703 MONROE AVE.
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562
Practice Address - Country:US
Practice Address - Phone:951-698-1168
Practice Address - Fax:951-698-0768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG100180261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherTAX ID
CA=========OtherTAX ID