Organization
FREDERICK FONG MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDERICK FONG MD (PRESIDENT)
(808) 531-7551
Entity
Organization
Contact information
Practice address
1380 LUSTIANA STREET, SUITE 514, HONOLULU, HI 96813-2441
(808) 531-7551
(808) 537-3652
Mailing address
1380 LUSTIANA STREET, SUITE 514, HONOLULU, HI 96813-2441
(808) 531-7551
(808) 537-3652
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD2477
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38893
BLUE CROSS
HI
05
—
52862201
—
HI
Enumeration date
01/09/2007
Last updated
08/22/2020
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