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General NPI Number Information
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NPI Number | 1467957167
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Entity Type | Individual
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Provider Name | DAVID ING
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Gender | Male
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Dates
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Enumeration Date | 03/26/2018
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Last Update Date | 12/06/2021
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Provider Practice Location Address
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Address Line | 401 PARADISE RD STE E
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City | MODESTO
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State | CA
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Zip | 95351-3163
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Country | US
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Telephone | 209-558-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 2800 BRADEN AVE APT 77
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City | MODESTO
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State | CA
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Zip | 95356-0655
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Country | US
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Telephone | 213-239-3187
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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