Provider Demographics
NPI:1750321634
Name:NG, HAZEL (RD)
Entity Type:Individual
Prefix:
First Name:HAZEL
Middle Name:
Last Name:NG
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 EL CAPITAN CT
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90601-1100
Mailing Address - Country:US
Mailing Address - Phone:626-285-0800
Mailing Address - Fax:626-285-0830
Practice Address - Street 1:889 S SAN GABRIEL BLVD
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-2724
Practice Address - Country:US
Practice Address - Phone:626-285-0800
Practice Address - Fax:626-285-0830
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA813739133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered