MEDICARE: DARREN NG OD INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	13319TLG	CA

General Provider Information

NPI Number	:	1003367012
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DARREN NG OD INC

Provider Business Mailing Address
First Line	:	3700 SAN PABLO AVE
Second Line	:	STE. 5
City	:	HERCULES
State	:	CA
Zip	:	94547-3968
Country	:	US
Telephone Number	:	510-741-9900
Fax Number	:	510-741-9910

Provider Business Practice Location Address
First Line	:	3700 SAN PABLO AVE
Second Line	:	STE. 5
City	:	HERCULES
State	:	CA
Zip	:	94547-3968
Country	:	US
Telephone Number	:	510-741-9900
Fax Number	:	510-741-9910

Authorized Official
Title or Position	:	PRESDIENT
Name	:	DR. DARREN NG
Credential	:	O.D.
Telephone Number	:	510-741-9900

Provider Enumeration Date	:	10/14/2016
Last Update Date	:	06/24/2024

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