Healthcare Provider Details
I. General information
NPI: 1174102800
Provider Name (Legal Business Name): CHING YEUNG DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/08/2021
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1411 S COLLEGEVILLE RD
COLLEGEVILLE PA
19426-2957
US
IV. Provider business mailing address
1006 WOLF ST
PHILADELPHIA PA
19148-3002
US
V. Phone/Fax
- Phone: 484-902-1893
- Fax:
- Phone: 917-238-2215
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 25MB12889300 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | OS022742 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: