Provider Demographics
NPI:1780638460
Name:HENG, MING K (MD)
Entity Type:Individual
Prefix:
First Name:MING
Middle Name:K
Last Name:HENG
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 1:500 PASEO CAMARILLO
Mailing Address - Street 2:STE 100
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-5900
Mailing Address - Country:US
Mailing Address - Phone:805-667-2801
Mailing Address - Fax:805-667-2865
Practice Address - Street 1:2361 E VINEYARD AVE
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2102
Practice Address - Country:US
Practice Address - Phone:805-981-3770
Practice Address - Fax:805-981-3767
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35047207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA050394OtherBLUE CROSS
CARHM08609FMedicaid
CA95-1683892OtherOTHER INSURANCE
CARHM18553HMedicaid
CARHM08608FMedicaid
CAZZT40394FMedicaid
CAWA35047BMedicare ID - Type UnspecifiedPPIN
CARHM18553HMedicaid
CA058553Medicare ID - Type UnspecifiedRH MEDICARE
CA050394Medicare ID - Type UnspecifiedMEDICARE
CAWA35047DMedicare ID - Type UnspecifiedPPIN
CAWA35047AMedicare ID - Type UnspecifiedPPIN
CAZZT40394FMedicaid
CAWA35047GMedicare ID - Type UnspecifiedPPIN
CAWA35047EMedicare ID - Type UnspecifiedPPIN
CARHM08609FMedicaid