Healthcare Provider Details

I. General information

NPI: 1467141580
Provider Name (Legal Business Name): MICHAEL CHONG SON DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2023
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 E THOMPSON PEAK PKWY
SCOTTSDALE AZ
85255-4109
US

IV. Provider business mailing address

7400 E THOMPSON PEAK PKWY
SCOTTSDALE AZ
85255-4109
US

V. Phone/Fax

Practice location:
  • Phone: 480-324-7000
  • Fax:
Mailing address:
  • Phone: 480-324-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number012638
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: