Provider Demographics
NPI:1982823522
Name:TONG, SANDRA ELAINE (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:ELAINE
Last Name:TONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 CHARLESTON RD
Mailing Address - Street 2:M11-4112
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94043-1218
Mailing Address - Country:US
Mailing Address - Phone:650-564-5046
Mailing Address - Fax:650-564-2990
Practice Address - Street 1:1950 CHARLESTON RD
Practice Address - Street 2:M11-4112
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94043-1218
Practice Address - Country:US
Practice Address - Phone:650-564-5046
Practice Address - Fax:650-564-2990
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA043759174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist