Provider Demographics
NPI:1306084926
Name:TON, PHONG T (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PHONG
Middle Name:T
Last Name:TON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:BRANDON
Other - Middle Name:T
Other - Last Name:TON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:7548 SEQUOIA LN
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-7732
Mailing Address - Country:US
Mailing Address - Phone:909-863-9612
Mailing Address - Fax:
Practice Address - Street 1:17284 SLOVER AVE
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92337-7584
Practice Address - Country:US
Practice Address - Phone:909-427-4523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51628183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist