Provider Demographics
NPI:1972485803
Name:DAVID C NG
Entity type:Organization
Organization Name:DAVID C NG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:CHANG
Authorized Official - Last Name:NG
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:805-497-7822
Mailing Address - Street 1:13960 BLACK ROCK CIR
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-5025
Mailing Address - Country:US
Mailing Address - Phone:805-497-7822
Mailing Address - Fax:805-293-6768
Practice Address - Street 1:123 HODENCAMP RD STE 101
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-5833
Practice Address - Country:US
Practice Address - Phone:805-497-7822
Practice Address - Fax:805-293-6768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty