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General NPI Number Information
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NPI Number | 1750463329
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Entity Type | Organization
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Legal Business Name | SUONG MY TUONG MD
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 09/26/2007
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Provider Practice Location Address
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Address Line | 5296 UNIVERSITY AVENUE SUITE J
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City | SAN DIEGO
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State | CA
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Zip | 92105-2269
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Country | US
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Telephone | 619-287-7835
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Fax | 619-287-2307
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Provider Business Mailing Address
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Address Line | 5296 UNIVERSITY AVENUE SUITE J
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City | SAN DIEGO
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State | CA
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Zip | 92105-2269
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Country | US
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Telephone | 619-287-7835
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Fax | 619-287-2307
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Authorized Official
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Title or Position | OWNER GENERAL PARTNER
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Name | SUONG MY TUONG
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Credential | MD
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Telephone | 619-287-7835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A36173
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License Number State | CA
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