Healthcare Provider Details

I. General information

NPI: 1922934637
Provider Name (Legal Business Name): JIMBY PAUL CULANCULAN TONGSON DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 S BALLENGER HWY
FLINT MI
48532-3638
US

IV. Provider business mailing address

14271 CLAREMONT DR # DT
SHELBY TOWNSHIP MI
48315-4966
US

V. Phone/Fax

Practice location:
  • Phone: 810-342-2000
  • Fax:
Mailing address:
  • Phone: 913-461-3465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: