Individual
DR. FONG-LIANG FAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2226 LILIHA STREET, SUITE 402, HONOLULU, HI 96817-1605
(808) 523-0166
(808) 528-4940
Mailing address
550 S BERETANIA ST, STE 403, HONOLULU, HI 96813-2496
(808) 523-0166
(808) 528-4940
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
3280
HI
208600000X
Surgery Physician
3280
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000BDSFG
MEDICARE
—
01
—
00N0053586
HMSA
—
01
—
04715601
ALOHACARE
—
05
—
04715601
—
HI
01
—
193072
HMA NEW
—
01
—
D3280
MDX
—
01
—
D36114
KAISER PERM
—
Enumeration date
11/20/2006
Last updated
11/29/2023
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