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Organization

KAREN ANN FONG MD

Active
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Organization

KAREN ANN FONG MD

Active
Other names
Asante Medical Group
Organization subpart
No

Provider details

NPI number
Authorized official
MS. KAREN ANN FONG MD (OWNER)
(805) 242-4455
Entity
Organization

Contact information

Practice address
1551 BISHOP ST, SUITE 310, SAN LUIS OBISPO, CA 93401-4635
(805) 242-4455
(805) 547-1395
Mailing address
1241 JOHNSON AVE, #322, SAN LUIS OBISPO, CA 93401-3306
(805) 242-4455
(805) 547-1395

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G70251
CA
208000000X
Pediatrics Physician
G70251
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G70251
CA MD LICENSE
CA
Enumeration date
10/25/2012
Last updated
03/06/2013
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