Provider Demographics
NPI:1700854585
Name:LING, GOW-NAN (MD)
Entity Type:Individual
Prefix:DR
First Name:GOW-NAN
Middle Name:
Last Name:LING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N GARFIELD AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-1170
Mailing Address - Country:US
Mailing Address - Phone:626-576-1221
Mailing Address - Fax:
Practice Address - Street 1:600 N GARFIELD AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1166
Practice Address - Country:US
Practice Address - Phone:626-576-1221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-09
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC40117207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC40117OtherSTATE LICENSE NUMBER
CAC40117OtherSTATE LICENSE NUMBER