MEDICARE: DAVID 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	68630	CA

General Provider Information

NPI Number	:	1518413004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID NG

Provider Business Mailing Address
First Line	:	6201 HOLLYWOOD BLVD STE 126
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-5363
Country	:	US
Telephone Number	:	323-467-7954
Fax Number	:

Provider Business Practice Location Address
First Line	:	6201 HOLLYWOOD BLVD STE 126
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-5363
Country	:	US
Telephone Number	:	323-467-7954
Fax Number	:	323-284-7575

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

Provider Enumeration Date	:	08/25/2016
Last Update Date	:	08/25/2016

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Directions to “ DAVID NG ” Practice Location

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