MEDICARE: AMY NG

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	183500000X	Pharmacist	71358	CA

General Provider Information

NPI Number	:	1215338116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY NG

Provider Business Mailing Address
First Line	:	11565 SAN PABLO AVE
Second Line	:
City	:	EL CERRITO
State	:	CA
Zip	:	94530-1951
Country	:	US
Telephone Number	:	510-234-9300
Fax Number	:

Provider Business Practice Location Address
First Line	:	11565 SAN PABLO AVE
Second Line	:
City	:	EL CERRITO
State	:	CA
Zip	:	94530-1951
Country	:	US
Telephone Number	:	510-234-9300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2014
Last Update Date	:	09/10/2014

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Directions to “ AMY NG ” Practice Location

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