Individual
LYNN M FONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
9754 TAPESTRY DR, GILROY, CA 95020-9634
(408) 847-1722
Mailing address
9754 TAPESTRY DR, GILROY, CA 95020-9634
(408) 847-1722
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
874025
CA
Other
Enumeration date
01/19/2010
Last updated
01/19/2010
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