Provider Demographics
NPI:1962439299
Name:TONG, IRENE Y (MD)
Entity Type:Individual
Prefix:DR
First Name:IRENE
Middle Name:Y
Last Name:TONG
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2750 E WASHINGTON BLVD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-1448
Mailing Address - Country:US
Mailing Address - Phone:626-296-2910
Mailing Address - Fax:626-296-2920
Practice Address - Street 1:2750 E WASHINGTON BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-1448
Practice Address - Country:US
Practice Address - Phone:626-296-2910
Practice Address - Fax:626-296-2920
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAG34761207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA46065Medicare UPIN