Individual
DERMET FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1955 COWELL BLVD, DAVIS, CA 95616-6325
(530) 757-7070
Mailing address
1955 COWELL BLVD, DAVIS, CA 95616-6325
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G42188
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G421880
—
CA
Enumeration date
11/10/2006
Last updated
07/08/2007
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