Provider Demographics
NPI:1912018789
Name:TON, THOMAS THAT (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:THAT
Last Name:TON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9898 RARITAN AVE
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-1047
Mailing Address - Country:US
Mailing Address - Phone:714-839-1977
Mailing Address - Fax:
Practice Address - Street 1:7761 GARDEN GROVE BLVD
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92841-4200
Practice Address - Country:US
Practice Address - Phone:714-898-8888
Practice Address - Fax:714-901-7580
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2022-03-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG78428207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG78428AMedicare UPIN