Healthcare Provider Details

I. General information

NPI: 1750658167
Provider Name (Legal Business Name): APOLINAR F TIONGSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2011
Last Update Date: 11/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 S MAIN ST
MILPITAS CA
95035
US

IV. Provider business mailing address

9022 LEMONA AVENUE
NORTH HILLS CA
91343
US

V. Phone/Fax

Practice location:
  • Phone: 888-678-7546
  • Fax:
Mailing address:
  • Phone: 818-339-4969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberA067316
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: