Healthcare Provider Details

I. General information

NPI: 1457533507
Provider Name (Legal Business Name): YEE-WING TONG M D INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2007
Last Update Date: 04/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 ENDEAVOR STE 304 SUITE 300
IRVINE CA
92618-3177
US

IV. Provider business mailing address

PO BOX 54188
IRVINE CA
92619-4188
US

V. Phone/Fax

Practice location:
  • Phone: 714-556-8664
  • Fax: 714-556-8665
Mailing address:
  • Phone: 714-556-8664
  • Fax: 714-556-8665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A9893
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberG29698
License Number StateCA

VIII. Authorized Official

Name: DR. ELAIN TONG
Title or Position: TREASURER
Credential: D.O.
Phone: 714-556-8664