Provider Demographics
NPI:1952041642
Name:TONG, NAM (RN)
Entity Type:Individual
Prefix:
First Name:NAM
Middle Name:
Last Name:TONG
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4950 W SUNSET BLVD STE 581
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-5821
Mailing Address - Country:US
Mailing Address - Phone:323-783-5363
Mailing Address - Fax:
Practice Address - Street 1:4950 W SUNSET BLVD STE 581
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5821
Practice Address - Country:US
Practice Address - Phone:323-783-5363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95033975163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy