MEDICARE: MYRON JOHN TONG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	204F00000X	Transplant Surgery Physician	A22458	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407839681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MYRON JOHN TONG MD

Provider Business Mailing Address
First Line	:	PO BOX 31309
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90031-0309
Country	:	US
Telephone Number	:	323-442-5100
Fax Number	:

Provider Business Practice Location Address
First Line	:	625 S FAIR OAKS AVE
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91105-2613
Country	:	US
Telephone Number	:	626-975-9788
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	10/27/2024

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