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Organization

WARREN H FONG MD INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WARREN H FONG MD (PRESIDENT)
(949) 574-1610
Entity
Organization

Contact information

Practice address
361 HOSPITAL RD, STE 530, NEWPORT BEACH, CA 92663-3522
(949) 574-1610
(949) 574-1613
Mailing address
361 HOSPITAL RD, STE 530, NEWPORT BEACH, CA 92663-3522
(949) 574-1610
(949) 574-1613

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
WG78726A
MEDICARE INDIVIDUAL PTAN
CA
Enumeration date
12/05/2005
Last updated
07/26/2010
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