Provider Demographics
NPI:1154951499
Name:TONGG, PHILIP MICHAEL JR (PA-C)
Entity type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:MICHAEL
Last Name:TONGG
Suffix:JR
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:2180 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-1625
Mailing Address - Country:US
Mailing Address - Phone:808-242-4267
Mailing Address - Fax:808-242-4292
Practice Address - Street 1:2180 MAIN ST
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1625
Practice Address - Country:US
Practice Address - Phone:808-242-4267
Practice Address - Fax:808-242-4292
Is Sole Proprietor?:No
Enumeration Date:2020-01-24
Last Update Date:2020-01-24
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical