Provider Demographics
NPI:1194431379
Name:NGAN, JASON (DC)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:NGAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 DUNSWELL AVE
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-2723
Mailing Address - Country:US
Mailing Address - Phone:626-592-3880
Mailing Address - Fax:
Practice Address - Street 1:880 S ATLANTIC BLVD STE 208
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-4775
Practice Address - Country:US
Practice Address - Phone:626-592-3880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC36559111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor