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General NPI Number Information
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NPI Number | 1710112941
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Entity Type | Individual
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Provider Name | DIANA NG MD
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Gender | Female
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Dates
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Enumeration Date | 05/18/2009
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Last Update Date | 08/30/2016
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Provider Practice Location Address
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Address Line | 9834 GENESEE AVE STE 200 EYECARE OF LA JOLLA
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City | LA JOLLA
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State | CA
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Zip | 92037-1225
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Country | US
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Telephone | 858-457-3050
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Fax | 858-457-0851
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Provider Business Mailing Address
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Address Line | 9834 GENESEE AVE STE 200
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City | LA JOLLA
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State | CA
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Zip | 92037
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Country | US
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Telephone | 858-457-3050
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Fax | 858-457-0851
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | A115695
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 251706
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License Number State | NY
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