Provider Demographics
NPI:1992757694
Name:TON, DANIEL DUY KHIEM THAT (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:DUY KHIEM THAT
Last Name:TON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1422 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-4110
Mailing Address - Country:US
Mailing Address - Phone:650-903-9500
Mailing Address - Fax:650-903-9500
Practice Address - Street 1:1422 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-4110
Practice Address - Country:US
Practice Address - Phone:650-903-9500
Practice Address - Fax:650-903-9500
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA83996207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A839960Medicaid
CA00A839960Medicare ID - Type Unspecified
CA00A839960Medicaid