| Mark L. Tong, Md Inc. | |
|
1000 Fowler Way Suite 1a Placerville CA 95667-5738 | |
| (530) 344-9200 | |
| (530) 344-9010 |
| Full Name | Mark L. Tong, Md Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 1000 Fowler Way, Placerville, California |
| Authorized Official Name and Position | Mark Lex Tong (CEO) |
| Authorized Official Contact | 5303449200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark L. Tong, Md Inc. 1000 Fowler Way Suite 1a Placerville CA 95667-5738 Ph: (530) 344-9200 | Mark L. Tong, Md Inc. 1000 Fowler Way Suite 1a Placerville CA 95667-5738 Ph: (530) 344-9200 |
| NPI Number | 1558388231 |
|---|---|
| Provider Enumeration Date | 07/17/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0941201818 |
|---|---|
| Medicare Enrollment ID | O20070118000596 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558388231 | NPI | - | NPPES |
| G080662 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G80662 (California) | Primary |
| Provider Name | Mark L Tong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851467880 PECOS PAC ID: 1850392721 Enrollment ID: I20070118000599 |
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