Provider Demographics
NPI:1932917945
Name:UNG, AI NGOC (XT)
Entity type:Individual
Prefix:
First Name:AI
Middle Name:NGOC
Last Name:UNG
Suffix:
Gender:F
Credentials:XT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 S CINDY PL APT C
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92802-4546
Mailing Address - Country:US
Mailing Address - Phone:714-391-6711
Mailing Address - Fax:
Practice Address - Street 1:5475 E LA PALMA AVE STE 209
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-2075
Practice Address - Country:US
Practice Address - Phone:714-202-2541
Practice Address - Fax:714-455-5792
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC20204171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty