Provider Demographics
NPI:1396495107
Name:NG, ARNOLD
Entity type:Individual
Prefix:
First Name:ARNOLD
Middle Name:
Last Name:NG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7345 MEDICAL CENTER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-1923
Mailing Address - Country:US
Mailing Address - Phone:818-715-0070
Mailing Address - Fax:818-715-0579
Practice Address - Street 1:7345 MEDICAL CENTER DR STE 100
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1923
Practice Address - Country:US
Practice Address - Phone:818-715-0070
Practice Address - Fax:818-715-0579
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH84738183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
5674836OtherNCPDP