Provider Demographics
NPI:1417622655
Name:NG, MATTHEW (PA-C)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:NG
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:100 E VALENCIA MESA DR STE 310
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3800
Mailing Address - Country:US
Mailing Address - Phone:714-734-3120
Mailing Address - Fax:
Practice Address - Street 1:18021 SKY PARK CIR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6523
Practice Address - Country:US
Practice Address - Phone:626-373-0002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-10
Last Update Date:2024-06-25
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant