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Individual

JUON-KIN K. FONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2844 SUMMIT ST, SUITE 103, OAKLAND, CA 94609-3637
(510) 834-1742
(510) 834-5315
Mailing address
2844 SUMMIT ST, SUITE 103, OAKLAND, CA 94609-3637
(510) 834-1742
(510) 834-5315

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G0-28848
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
94-2806866
FEDERAL TAX ID
Enumeration date
01/13/2007
Last updated
06/11/2008
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