Provider Demographics
NPI:1740307511
Name:MA, TING PONG (ACUPUNCTURIST)
Entity type:Individual
Prefix:DR
First Name:TING
Middle Name:PONG
Last Name:MA
Suffix:
Gender:M
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2336 ROSE ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-2437
Mailing Address - Country:US
Mailing Address - Phone:808-688-6536
Mailing Address - Fax:
Practice Address - Street 1:2336 ROSE ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-2437
Practice Address - Country:US
Practice Address - Phone:808-688-6536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI256171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist