Provider Demographics
NPI:1255990461
Name:LING, MICHAEL CHUNGHAN (APRN, FNP-C)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:CHUNGHAN
Last Name:LING
Suffix:
Gender:M
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17502 CALIENTE AVE
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-9013
Mailing Address - Country:US
Mailing Address - Phone:858-231-6794
Mailing Address - Fax:
Practice Address - Street 1:21750 CENTER COURT DR. S
Practice Address - Street 2:SUITE 650
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703
Practice Address - Country:US
Practice Address - Phone:323-628-8671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95008846363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily