Frederick Fong MD Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD2477 Issued in HI

Legal business name

FREDERICK FONG MD INC

Practice address

1380 Lustiana Street
Suite 514
Honolulu, HI 96813-2441

Phone

(808) 531-7551

Fax

(808) 537-3652

NPI assigned

Jan 9, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Frederick Fong, MDNPI 1588828727

Title

President

Phone

(808) 531-7551

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Frederick Fong, M.D.

  • Internal Medicine Physician
  • Honolulu, HI
  • NPI 1588828727
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013066992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 LUSTIANA STREET",
            "address_2": "SUITE 514",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132441",
            "telephone_number": "808-531-7551",
            "fax_number": "808-537-3652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 LUSTIANA STREET",
            "address_2": "SUITE 514",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132441",
            "telephone_number": "808-531-7551",
            "fax_number": "808-537-3652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICK FONG MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FONG",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-531-7551",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD2477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "38893",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "52862201",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John T Frauens, MD
• Kevin Frazier, MPT
• La-Tisha Frazier, MD
• Michael Fredeluces
• Frederick a Harada M D LLC
• Free Bird Counseling LLC
• Freedom Recovery Services, Inc.
• Tomomi Freeman, MAT
• Bret Freemyer
• Krister Paul Freese, M.D.

• Internal Medicine Physician in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Internal Medicine Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.