1013921907 NPI number — GEORGE K CHING JR. MD

Table of content: GEORGE K CHING JR. MD (NPI 1013921907)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013921907 NPI number — GEORGE K CHING JR. MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHING
Provider First Name:
GEORGE
Provider Middle Name:
K
Provider Name Prefix Text:
Provider Name Suffix Text:
JR.
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013921907
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
116 N PLAZA ST
Provider Second Line Business Mailing Address:
VALLEY EYE CARE MEDICAL GROUP INC
Provider Business Mailing Address City Name:
BRAWLEY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92227-2426
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-344-4330
Provider Business Mailing Address Fax Number:
760-344-6956

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
116 N PLAZA ST
Provider Second Line Business Practice Location Address:
VALLEY EYE CARE MEDICAL GROUP INC
Provider Business Practice Location Address City Name:
BRAWLEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92227-2426
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-344-4330
Provider Business Practice Location Address Fax Number:
760-344-6956
Provider Enumeration Date:
07/28/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  G037837 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00G378370 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".