Provider Demographics
NPI:1245512854
Name:NG, GLORIA (PA)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:NG
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:18502 GRIDLEY RD
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701-5406
Mailing Address - Country:US
Mailing Address - Phone:562-865-6160
Mailing Address - Fax:562-468-4315
Practice Address - Street 1:18502 GRIDLEY RD
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701-5436
Practice Address - Country:US
Practice Address - Phone:562-865-6160
Practice Address - Fax:562-468-4315
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2015-10-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA21773363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant