Provider Demographics
NPI:1902382989
Name:TING, RONALD JAMES HIDALGO (ATC)
Entity Type:Individual
Prefix:
First Name:RONALD JAMES
Middle Name:HIDALGO
Last Name:TING
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3764 MORTENSEN RD
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-4150
Mailing Address - Country:US
Mailing Address - Phone:510-708-3263
Mailing Address - Fax:
Practice Address - Street 1:3764 MORTENSEN RD
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-4150
Practice Address - Country:US
Practice Address - Phone:510-708-3263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-12
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer