Provider Demographics
NPI:1619016300
Name:PRONG, TZERLIN (DC)
Entity Type:Individual
Prefix:DR
First Name:TZERLIN
Middle Name:
Last Name:PRONG
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 1:1722 DESIRE AVE
Mailing Address - Street 2:SUITE #205
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-2968
Mailing Address - Country:US
Mailing Address - Phone:626-581-3578
Mailing Address - Fax:626-581-3450
Practice Address - Street 1:1722 DESIRE AVE
Practice Address - Street 2:SUITE #205
Practice Address - City:ROWLAND HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91748-2968
Practice Address - Country:US
Practice Address - Phone:626-581-3578
Practice Address - Fax:626-581-3450
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23459111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation