Provider Demographics
NPI:1497348411
Name:TONG, DAMON HENRY (DC)
Entity Type:Individual
Prefix:DR
First Name:DAMON
Middle Name:HENRY
Last Name:TONG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8950 W OLYMPIC BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3576
Mailing Address - Country:US
Mailing Address - Phone:510-227-0569
Mailing Address - Fax:
Practice Address - Street 1:8950 W OLYMPIC BLVD STE 206
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3576
Practice Address - Country:US
Practice Address - Phone:510-227-0569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-20
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC36033111N00000X
CADC36036111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor