Provider Demographics
NPI:1568481554
Name:TONG, SHUEMI (MD)
Entity Type:Individual
Prefix:DR
First Name:SHUEMI
Middle Name:
Last Name:TONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 W HOBSONWAY
Mailing Address - Street 2:
Mailing Address - City:BLYTHE
Mailing Address - State:CA
Mailing Address - Zip Code:92225-1616
Mailing Address - Country:US
Mailing Address - Phone:760-922-7337
Mailing Address - Fax:760-922-9992
Practice Address - Street 1:149 W HOBSONWAY
Practice Address - Street 2:
Practice Address - City:BLYTHE
Practice Address - State:CA
Practice Address - Zip Code:92225-1616
Practice Address - Country:US
Practice Address - Phone:760-922-7337
Practice Address - Fax:760-922-9992
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71230208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A712300Medicaid