Individual provider Active NPI

Mark Lex Tong, M.D.

  • Family Medicine Physician
  • Placerville, CA
National Provider Identifier
1851467880
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G80662 Issued in CA
Practice address
1000 Fowler Way
Suite 1a
Placerville, CA 95667-5738
Phone
(530) 344-9200
Fax
(530) 344-9010
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G80662 CA Primary

Addresses

Primary practice location

1000 Fowler Way
Suite 1a
Placerville, CA 95667-5738

Mailing address

1000 Fowler Way
Suite 1a
Placerville, CA 95667-5738
Phone (530) 344-9200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070118000599 CA Practitioner - Family Practice 1850392721

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G80662CAMDFamily Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851467880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 FOWLER WAY",
            "address_2": "SUITE 1A",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956675738",
            "telephone_number": "530-344-9200",
            "fax_number": "530-344-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 FOWLER WAY",
            "address_2": "SUITE 1A",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956675738",
            "telephone_number": "530-344-9200",
            "fax_number": "530-344-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TONG",
        "first_name": "MARK",
        "middle_name": "LEX",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G80662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placerville, CA

Sources for this page

Verify at the official NPI Registry.