Individual
DR. ALLEN GARY FONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2039 FOREST AVE, STE # 201, SAN JOSE, CA 95128
(408) 806-1565
(408) 741-1595
Mailing address
P.O. BOX 3058, SARATOGA, CA 95070
(408) 806-1565
(408) 741-1595
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
C36904
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AF7272672
BNDD
—
Enumeration date
09/02/2011
Last updated
09/02/2011
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