Individual
BRIAN MATTHEW FONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17100 NORWALK BLVD STE 107, CERRITOS, CA 90703-2750
(562) 402-1525
(562) 867-7046
Mailing address
17100 NORWALK BLVD STE 107, CERRITOS, CA 90703-2750
(562) 402-1525
(562) 867-7046
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
14146TLG
CA
Other
Enumeration date
06/27/2011
Last updated
01/19/2022
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