Individual
FONG LAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7650 NEWCASTLE RD, STOCKTON, CA 95215-9663
(209) 944-6343
Mailing address
7650 NEWCASTLE RD, STOCKTON, CA 95215-9663
(209) 944-6343
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
A30554
CA
Other
Enumeration date
08/13/2010
Last updated
08/13/2010
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