Healthcare Provider Details

I. General information

NPI: 1518064526
Provider Name (Legal Business Name): LOFTON & TONG, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

361 S MONROE ST
SAN JOSE CA
95128-5107
US

IV. Provider business mailing address

2100 FOREST AVE # 112
SAN JOSE CA
95128-1422
US

V. Phone/Fax

Practice location:
  • Phone: 408-298-7587
  • Fax: 408-294-7587
Mailing address:
  • Phone: 408-298-7587
  • Fax: 408-294-7587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471M1202X
TaxonomyMagnetic Resonance Imaging Radiologic Technologist
License Number
License Number StateCA

VIII. Authorized Official

Name: MR. PHILL L TONG
Title or Position: OWNER/MGR.
Credential:
Phone: 408-298-7587