Individual
MR. JOHN FONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1130 MONACO CT, STOCKTON, CA 95207
(209) 478-2060
(209) 478-3175
Mailing address
PO BOX 986, WOODBRIDGE, CA 95258-0986
(209) 339-9036
(209) 339-1901
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G49494
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G494940
—
CA
Enumeration date
01/27/2006
Last updated
01/06/2010
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