Individual
SHIRLEY FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9985 SIERRA AVE, KAISER PERMANENTE, FONTANA, CA 92335-6720
(909) 427-5711
Mailing address
9985 SIERRA AVE, KAISER PERMANENTE, FONTANA, CA 92335-6720
(909) 427-5711
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
224420
NY
207VE0102X
Reproductive Endocrinology Physician
25MA07509000
NJ
207VE0102X
Reproductive Endocrinology Physician
Primary
A90666
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2570574
—
NY
Enumeration date
06/29/2006
Last updated
11/30/2021
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