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General NPI Number Information
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NPI Number | 1235029026
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Entity Type | Organization
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Legal Business Name | KP TONG, DPM, PODIATRY CORPORATION
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Dates
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Enumeration Date | 07/03/2025
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 31 PARK CIR
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City | SAUSALITO
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State | CA
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Zip | 94965-1117
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Country | US
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Telephone | 206-697-4998
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Fax |
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Provider Business Mailing Address
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Address Line | 31 PARK CIR
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City | SAUSALITO
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State | CA
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Zip | 94965-1117
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KHANH PHUONG TONG
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Credential | DPM
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Telephone | 206-697-4998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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