Provider Demographics
NPI:1699545467
Name:ONG, STEVEN
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:ONG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4680 S MARBLE ST
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-6881
Mailing Address - Country:US
Mailing Address - Phone:480-278-1787
Mailing Address - Fax:
Practice Address - Street 1:14574 SUNLAND GIN RD
Practice Address - Street 2:
Practice Address - City:ARIZONA CITY
Practice Address - State:AZ
Practice Address - Zip Code:85123
Practice Address - Country:US
Practice Address - Phone:520-231-6272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS026816183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist