Healthcare Provider Details

I. General information

NPI: 1700415999
Provider Name (Legal Business Name): KONRAD H NG, MD INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2020
Last Update Date: 04/08/2020
Certification Date: 04/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 WEBSTER ST STE 314
SAN FRANCISCO CA
94115-2377
US

IV. Provider business mailing address

2100 WEBSTER ST STE 314
SAN FRANCISCO CA
94115-2377
US

V. Phone/Fax

Practice location:
  • Phone: 415-737-0555
  • Fax: 415-737-0595
Mailing address:
  • Phone: 415-737-0555
  • Fax: 415-737-0595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KONRAD NG
Title or Position: PHYSICIAN
Credential: MD
Phone: 415-737-0555