Provider Demographics
NPI:1700047875
Name:NG, TINA T (MD)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:T
Last Name:NG
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 2828
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92878-2828
Mailing Address - Country:US
Mailing Address - Phone:951-278-8870
Mailing Address - Fax:951-278-8913
Practice Address - Street 1:3660 PARK SIERRA DR
Practice Address - Street 2:SUITE 105
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-3081
Practice Address - Country:US
Practice Address - Phone:951-278-8870
Practice Address - Fax:951-278-8913
Is Sole Proprietor?:No
Enumeration Date:2008-06-21
Last Update Date:2016-01-06
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Provider Licenses
StateLicense IDTaxonomies
CAA98265208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery