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Individual

JEFFREY JOHN ING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1617 SAINT MARKS PLZ, SUITE D, STOCKTON, CA 95207-6423
(209) 478-1797
(209) 478-1224
Mailing address
388 YPAO RD, TAMUNING, GU 96913-3701
(671) 646-8881
(671) 646-1292

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
G78322
CA
207W00000X
Ophthalmology Physician
Primary
M-2308
GU

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G783220
CA
Enumeration date
08/24/2006
Last updated
04/25/2022
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