Provider Demographics
NPI:1205860988
Name:TON, KRIS (PA-C)
Entity Type:Individual
Prefix:
First Name:KRIS
Middle Name:
Last Name:TON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:PHUC
Other - Middle Name:KRIS
Other - Last Name:TON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:11190 WARNER AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-4019
Mailing Address - Country:US
Mailing Address - Phone:714-241-7000
Mailing Address - Fax:714-241-7003
Practice Address - Street 1:11190 WARNER AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-4019
Practice Address - Country:US
Practice Address - Phone:714-241-7000
Practice Address - Fax:714-241-7003
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA17363363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA17363OtherPHYSICIAN ASST LICENSE
CAPA17363Medicare ID - Type UnspecifiedMEDICARE PROVIDER
CAQ16383Medicare UPIN