Provider Demographics
NPI:1265523351
Name:NG, DANIEL ALLEN (MD)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:ALLEN
Last Name:NG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:510 SUPERIOR AVE
Mailing Address - Street 2:STE 200G
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3663
Mailing Address - Country:US
Mailing Address - Phone:949-791-6767
Mailing Address - Fax:949-791-6768
Practice Address - Street 1:510 SUPERIOR AVE
Practice Address - Street 2:STE 200G
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3663
Practice Address - Country:US
Practice Address - Phone:949-791-6767
Practice Address - Fax:949-791-6768
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2015-11-03
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Provider Licenses
StateLicense IDTaxonomies
CAG70052208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG70052AOtherPIN
CA00G700520Medicaid
G04258Medicare UPIN
CAW13497Medicare ID - Type UnspecifiedGROUP