Individual provider Active NPI

David S NG, O.D.

  • Optometrist
  • Concord, CA
National Provider Identifier
1962584698
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6095T Issued in CA
Practice address
1755 Willow Pass Rd
Concord, CA 94520-2613
Phone
(925) 685-2767
Fax
(925) 685-2772
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6095T CA Primary

Addresses

Primary practice location

1755 Willow Pass Rd
Concord, CA 94520-2613

Mailing address

1755 Willow Pass Rd
Concord, CA 94520-2613
Phone (925) 685-2767

Other identifiers 1

IdentifierTypeStateIssuer
SD0060950MedicaidCA

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100813000652 CA Practitioner - Optometry 8325172216 Practice locations: Concord, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6095TCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1962584698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 WILLOW PASS RD",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202613",
            "telephone_number": "925-685-2767",
            "fax_number": "925-685-2772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 WILLOW PASS RD",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202613",
            "telephone_number": "925-685-2767",
            "fax_number": "925-685-2772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NG",
        "first_name": "DAVID",
        "middle_name": "S",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "6095T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0060950",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

Verify at the official NPI Registry.