Healthcare Provider Details

I. General information

NPI: 1306012901
Provider Name (Legal Business Name): OKKY TJHING SIONG OEI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2008
Last Update Date: 02/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15030 N HAYDEN RD STE 120
SCOTTSDALE AZ
85260-2564
US

IV. Provider business mailing address

15030 N HAYDEN RD STE 120
SCOTTSDALE AZ
85260-2564
US

V. Phone/Fax

Practice location:
  • Phone: 480-659-5470
  • Fax: 480-361-7388
Mailing address:
  • Phone: 480-659-5470
  • Fax: 480-361-7388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number13583
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: