Individual
DR. NORA LILLIAN FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
425 15TH ST., MANHATTAN BEACH, CA 90266
(310) 802-8760
Mailing address
PO BOX 3266, MANHATTAN BEACH, CA 90266
(310) 546-7686
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
G65297
CA
Other
Enumeration date
10/26/2015
Last updated
10/26/2015
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