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General NPI Number Information
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NPI Number | 1003803685
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Entity Type | Individual
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Provider Name | KIM NG M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/29/2005
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 12370 HESPERIA RD STE 17
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City | VICTORVILLE
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State | CA
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Zip | 92395-5808
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Country | US
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Telephone | 760-388-0071
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Fax | 760-513-9832
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Provider Business Mailing Address
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Address Line | 18000 STUDEBAKER RD STE 800
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City | CERRITOS
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State | CA
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Zip | 90703-2671
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Country | US
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Telephone | 562-735-3226
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A33989
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | MD60377608
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | A33989
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License Number State | CA
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