Provider Demographics
NPI:1144286618
Name:TSONG, PAUL HEN-LIN (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:HEN-LIN
Last Name:TSONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2810 N SWAN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-6305
Mailing Address - Country:US
Mailing Address - Phone:520-445-6003
Mailing Address - Fax:520-721-5811
Practice Address - Street 1:2810 N SWAN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-6305
Practice Address - Country:US
Practice Address - Phone:520-445-6003
Practice Address - Fax:520-721-5811
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30296207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ704230Medicaid
AZ704230Medicaid
70678Medicare ID - Type Unspecified