Provider Demographics
NPI:1932280583
Name:NG, LAWRENCE M (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:M
Last Name:NG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:101 CALLAN AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-4854
Mailing Address - Country:US
Mailing Address - Phone:510-357-7077
Mailing Address - Fax:510-357-4363
Practice Address - Street 1:101 CALLAN AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4854
Practice Address - Country:US
Practice Address - Phone:510-357-7077
Practice Address - Fax:510-357-4363
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2019-01-17
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Provider Licenses
StateLicense IDTaxonomies
CAA24151208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A241510Medicaid
CA00A241510Medicaid