Basic Information
Provider Information
NPI: 1649352196
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MOK
FirstName: IRVING
MiddleName: OI-LING
NamePrefix: MR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 720 SACRAMENTO ST
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941082505
CountryCode: US
TelephoneNumber: 4153924453
FaxNumber:  
Practice Location
Address1: 720 SACRAMENTO ST
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941082505
CountryCode: US
TelephoneNumber: 4153924453
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/20/2006
LastUpdateDate: 03/07/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  N Behavioral Health & Social Service ProvidersCounselorMental Health
106H00000XLMFT49179CAY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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