Healthcare Provider Details

I. General information

NPI: 1184535957
Provider Name (Legal Business Name): CHADWICK NG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 E ALOSTA AVE
AZUSA CA
91702-2701
US

IV. Provider business mailing address

546 GREEN ST APT 2
SAN FRANCISCO CA
94133-3928
US

V. Phone/Fax

Practice location:
  • Phone: 626-969-3434
  • Fax:
Mailing address:
  • Phone: 650-954-0912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: