Provider Demographics
NPI:1568276665
Name:TIONGSON, JOSEPH ANGELO LIM (PHARMD, MBA)
Entity type:Individual
Prefix:
First Name:JOSEPH ANGELO
Middle Name:LIM
Last Name:TIONGSON
Suffix:
Gender:M
Credentials:PHARMD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2669 W SERENO PL
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-2018
Mailing Address - Country:US
Mailing Address - Phone:714-262-2035
Mailing Address - Fax:
Practice Address - Street 1:2669 W SERENO PL
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-2018
Practice Address - Country:US
Practice Address - Phone:714-262-2035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79387183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist