Healthcare Provider Details

I. General information

NPI: 1790858413
Provider Name (Legal Business Name): THOMAS T ENG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

341 MAGNOLIA AVE STE 102
CORONA CA
92879-3331
US

IV. Provider business mailing address

25186 HANCOCK AVE STE 110
MURRIETA CA
92562-5998
US

V. Phone/Fax

Practice location:
  • Phone: 951-592-3662
  • Fax: 951-521-1567
Mailing address:
  • Phone: 619-425-3840
  • Fax: 619-425-3842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA040273
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA40273
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: