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General NPI Number Information
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NPI Number | 1467503953
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Entity Type | Individual
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Provider Name | WHITNEY D NG O.D.
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Gender | Female
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Dates
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Enumeration Date | 01/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4950 PACIFIC AVE WEBERSTOWN SHOPPING CTR
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City | STOCKTON
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State | CA
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Zip | 95207-6307
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Country | US
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Telephone | 209-477-4114
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Fax | 209-477-9871
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Provider Business Mailing Address
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Address Line | 700 EL CAMINO REAL STE 160
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City | MENLO PARK
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State | CA
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Zip | 94025-4847
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Country | US
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Telephone | 650-329-8182
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Fax | 650-329-1069
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 11712
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License Number State | CA
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