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DR. MICHAEL WILLIAM FONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1520 SAN PABLO ST, SUITE 1000, LOS ANGELES, CA 90033-5310
(323) 442-5100
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(323) 442-6130

Taxonomy

Speciality
Code
Description
License number
State
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
Primary
A114374
CA
207RC0000X
Cardiovascular Disease Physician
243025-1
NY
207RC0000X
Cardiovascular Disease Physician
A 114374
CA

Other

Enumeration date
08/01/2006
Last updated
11/27/2023
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