# DR. BRIAN LEE FONG

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1982690095
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 10265R | LA | Yes |
| 207X00000X | Orthopaedic Surgery Physician | MD7157 | HI | — |

## Other

- **Enumeration date:** 09/23/2005
- **Last updated:** 08/31/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1194920001 | DME MEDICARE | — |
| 01 | — | 200030274 | RAILROAD MEDICARE | — |
| 01 | — | C7760 | BLUE CROSS | — |