Provider Demographics
NPI:1215506829
Name:NG, ALLEN (CMT)
Entity type:Individual
Prefix:
First Name:ALLEN
Middle Name:
Last Name:NG
Suffix:
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3108 SAN ANDREAS DR
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-2717
Mailing Address - Country:US
Mailing Address - Phone:510-375-6681
Mailing Address - Fax:
Practice Address - Street 1:3108 SAN ANDREAS DR
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-2717
Practice Address - Country:US
Practice Address - Phone:510-375-6681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-18
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA74326225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist