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NPI Code Detail

MEDICARE: MARK L. TONG, MD INC.

MEDICARE: MARK L. TONG, MD INC.
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
1207Q00000XFamily Medicine PhysicianG80662CA

Other Identifiers

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

General Provider Information

NPI Number : 1558388231
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARK L. TONG, MD INC.
Provider Business Mailing Address
First Line : 1000 FOWLER WAY
Second Line : SUITE 1A
City : PLACERVILLE
State : CA
Zip : 95667-5738
Country : US
Telephone Number : 530-344-9200
Fax Number : 530-344-9010
Provider Business Practice Location Address
First Line : 1000 FOWLER WAY
Second Line : SUITE 1A
City : PLACERVILLE
State : CA
Zip : 95667-5738
Country : US
Telephone Number : 530-344-9200
Fax Number : 530-344-9010
Authorized Official
Title or Position : CEO
Name : DR. MARK LEX TONG
Credential : MD
Telephone Number : 530-344-9200
Provider Enumeration Date : 07/17/2006
Last Update Date : 08/22/2020

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