Provider Demographics
NPI:1710051214
Name:NG, DANIEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:NG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4444 GEARY BLVD STE 211
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-3013
Mailing Address - Country:US
Mailing Address - Phone:415-386-7169
Mailing Address - Fax:415-386-7178
Practice Address - Street 1:4444 GEARY BLVD STE 211
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-3013
Practice Address - Country:US
Practice Address - Phone:415-386-7169
Practice Address - Fax:415-386-7178
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC002204171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA943212528OtherEIN