Healthcare Provider Details

I. General information

NPI: 1124057393
Provider Name (Legal Business Name): ANSELM LU SING HII M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 COLUMBIA
ALISO VIEJO CA
92656-1460
US

IV. Provider business mailing address

31 COLUMBIA
ALISO VIEJO CA
92656-2126
US

V. Phone/Fax

Practice location:
  • Phone: 949-425-5713
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License NumberA66624
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: