Provider Demographics
NPI:1427158294
Name:KARING PEDIATRICS MEDICAL GROUP
Entity type:Organization
Organization Name:KARING PEDIATRICS MEDICAL GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SONG
Authorized Official - Middle Name:NGO
Authorized Official - Last Name:TAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-491-9292
Mailing Address - Street 1:936 PINE AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-4326
Mailing Address - Country:US
Mailing Address - Phone:562-269-5658
Mailing Address - Fax:562-495-1878
Practice Address - Street 1:936 PINE AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-4326
Practice Address - Country:US
Practice Address - Phone:562-269-5658
Practice Address - Fax:562-495-1878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty