Provider Demographics
NPI:1053144741
Name:ELAIN WEN-SHANG TONG, DO INC
Entity type:Organization
Organization Name:ELAIN WEN-SHANG TONG, DO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TONG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:714-556-8664
Mailing Address - Street 1:18 ENDEAVOR STE 304
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3177
Mailing Address - Country:US
Mailing Address - Phone:714-556-8664
Mailing Address - Fax:714-556-8665
Practice Address - Street 1:18 ENDEAVOR STE 304
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3177
Practice Address - Country:US
Practice Address - Phone:714-556-8664
Practice Address - Fax:714-556-8665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-20
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty