Provider Demographics
NPI:1184676850
Name:OHN, TONY M (MD)
Entity Type:Individual
Prefix:
First Name:TONY
Middle Name:M
Last Name:OHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:HTOO
Other - Middle Name:MAUNG
Other - Last Name:OHN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2352 TUSCANY AVE
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-9685
Mailing Address - Country:US
Mailing Address - Phone:530-407-3919
Mailing Address - Fax:815-625-2747
Practice Address - Street 1:2352 TUSCANY AVE
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-9685
Practice Address - Country:US
Practice Address - Phone:530-407-3919
Practice Address - Fax:815-625-2747
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2022-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036089609207P00000X
CAC52385207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF95134Medicare UPIN