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General NPI Number Information
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NPI Number | 1730326026
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Entity Type | Individual
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Provider Name | DR. PAUL KENG TAING
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Gender | Male
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Dates
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Enumeration Date | 01/08/2009
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Last Update Date | 01/08/2009
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Provider Practice Location Address
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Address Line | 4601 DALE RD
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City | MODESTO
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State | CA
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Zip | 95356-9718
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Country | US
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Telephone | 209-735-6950
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Fax |
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Provider Business Mailing Address
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Address Line | 2809 SAFFRON WAY
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City | STOCKTON
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State | CA
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Zip | 95210-1744
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Country | US
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Telephone | 209-952-4879
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 61364
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License Number State | CA
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