Provider Demographics
NPI:1427129337
Name:CUYEGKENG, THOMAS X (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:X
Last Name:CUYEGKENG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 E VALENCIA MESA DR STE 311
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3800
Mailing Address - Country:US
Mailing Address - Phone:714-446-5590
Mailing Address - Fax:
Practice Address - Street 1:100 E VALENCIA MESA DR STE 311
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3800
Practice Address - Country:US
Practice Address - Phone:714-446-5590
Practice Address - Fax:714-446-5592
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2022-02-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA53949207QG0300X, 207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine