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General NPI Number Information
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NPI Number | 1902420656
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Entity Type | Individual
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Provider Name | JUSTIN NG OD
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Gender | Male
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Dates
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Enumeration Date | 05/28/2020
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Last Update Date | 01/03/2026
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Provider Practice Location Address
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Address Line | 150 S NEVADA HIGHWAY 160 STE 14
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City | PAHRUMP
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State | NV
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Zip | 89048-2133
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Country | US
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Telephone | 775-997-2020
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Fax | 775-540-0009
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Provider Business Mailing Address
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Address Line | 150 S NEVADA HIGHWAY 160 STE 14
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City | PAHRUMP
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State | NV
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Zip | 89048-2133
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Country | US
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Telephone | 775-997-2020
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Fax | 775-540-0009
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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 | 1074
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License Number State | NV
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