Provider Demographics
NPI:1497594097
Name:ARCIAGA, NENA TONG
Entity type:Individual
Prefix:
First Name:NENA
Middle Name:TONG
Last Name:ARCIAGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8439 WHITE OAK AVE STE 1038439
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-0621
Mailing Address - Country:US
Mailing Address - Phone:818-532-2222
Mailing Address - Fax:
Practice Address - Street 1:8439 WHITE OAK AVE STE 1038439
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-0621
Practice Address - Country:US
Practice Address - Phone:818-532-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG56286207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty