Individual provider Active NPI

Lawrence M NG, M.D.

  • Pediatrics Physician
  • San Leandro, CA
National Provider Identifier
1932280583
Registry record updated Jan 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A24151 Issued in CA
Practice address
101 Callan Ave
Suite 105
San Leandro, CA 94577-4854
Phone
(510) 357-7077
Fax
(510) 357-4363
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A24151 CA Primary

Addresses

Primary practice location

101 Callan Ave
Suite 105
San Leandro, CA 94577-4854

Mailing address

101 Callan Ave
Suite 105
San Leandro, CA 94577-4854
Phone (510) 357-7077

Other identifiers 1

IdentifierTypeStateIssuer
00A241510MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190123002941 CA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 7719224138

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A24151CAMDPediatrics Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1932280583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CALLAN AVE",
            "address_2": "SUITE 105",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774854",
            "telephone_number": "510-357-7077",
            "fax_number": "510-357-4363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CALLAN AVE",
            "address_2": "SUITE 105",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774854",
            "telephone_number": "510-357-7077",
            "fax_number": "510-357-4363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NG",
        "first_name": "LAWRENCE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A24151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A241510",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

Verify at the official NPI Registry.