MEDICARE: DR. IRENE Y. TONG M.D.

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	207RR0500X	Rheumatology Physician	G34761	CA

General Provider Information

NPI Number	:	1962439299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IRENE Y. TONG M.D.

Provider Business Mailing Address
First Line	:	2750 E WASHINGTON BLVD
Second Line	:	SUITE 120
City	:	PASADENA
State	:	CA
Zip	:	91107-1448
Country	:	US
Telephone Number	:	626-296-2910
Fax Number	:	626-296-2920

Provider Business Practice Location Address
First Line	:	2750 E WASHINGTON BLVD
Second Line	:	SUITE 120
City	:	PASADENA
State	:	CA
Zip	:	91107-1448
Country	:	US
Telephone Number	:	626-296-2910
Fax Number	:	626-296-2920

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

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	07/08/2007

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