Active NPI
Amanda Fong
- Pharmacist
- San Diego, CA
National Provider Identifier
1073235206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 86129
- Practice address
- 200 W Arbor Dr
San Diego, CA 92103-9000 - Phone
- (619) 543-6222
- NPI assigned
- Sep 14, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 86129 | CA | Primary |
Addresses
Primary practice location
200 W Arbor Dr
San Diego, CA 92103-9000
Mailing address
4647 Idaho St Unit 1
San Diego, CA 92116-3161
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663113600000",
"number": "1073235206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4647 IDAHO ST UNIT 1",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921163161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 W ARBOR DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921039000",
"telephone_number": "619-543-6222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONG",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-14",
"last_updated": "2022-09-14",
"certification_date": "2022-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "86129",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.