Provider Demographics
NPI:1487945481
Name:CARSON LING MD A MEDICAL CORPORATION
Entity type:Organization
Organization Name:CARSON LING MD A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARSON
Authorized Official - Middle Name:H
Authorized Official - Last Name:LING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-636-3032
Mailing Address - Street 1:9896 GARDEN GROVE BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92844-1643
Mailing Address - Country:US
Mailing Address - Phone:714-636-3032
Mailing Address - Fax:714-770-8236
Practice Address - Street 1:9896 GARDEN GROVE BLVD
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844-1643
Practice Address - Country:US
Practice Address - Phone:714-636-3032
Practice Address - Fax:714-770-8236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-25
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA90819208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABH578WMedicare PIN
CAFA554AMedicare PIN