Provider Demographics
NPI:1578208542
Name:ONG, MALINA PISEY
Entity Type:Individual
Prefix:
First Name:MALINA
Middle Name:PISEY
Last Name:ONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3137 W 7670 S
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-2866
Mailing Address - Country:US
Mailing Address - Phone:385-237-7594
Mailing Address - Fax:
Practice Address - Street 1:3137 W 7670 S
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84084-2866
Practice Address - Country:US
Practice Address - Phone:385-237-7594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program