Healthcare Provider Details

I. General information

NPI: 1780631572
Provider Name (Legal Business Name): BING SIANG GAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ST. JOSEPH'S HLTH CTRE 268 GROSVENOR STREET
LONDON ON
N6A4L6
CA

IV. Provider business mailing address

ST. JOSEPH'S HEALTH CENTER 268 GROSVENOR STREET
LONDON ON
N6A4L6
CA

V. Phone/Fax

Practice location:
  • Phone: 519-646-6097
  • Fax:
Mailing address:
  • Phone: 519-646-6097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number81354
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: