Brian Matthew Fong

Primary specialty

OptometristTaxonomy code 152W00000X

License

14146TLG Issued in CA

Practice address

17100 Norwalk Blvd Ste 107
Cerritos, CA 90703-2750

Phone

(562) 402-1525

Fax

(562) 867-7046

NPI assigned

Jun 27, 2011

Last updated

Jan 19, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Brian Matthew Fong Professional name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brian Fong OD Inc

  • Optometrist
  • Cerritos, CA
  • NPI 1518836303
  Medicare reassignment NPD Authorized official
• Eye Care West Optometry

  • Optometrist
  • Bellflower, CA
  • NPI 1801826813
  Medicare reassignment NPD
• Gerry Gee, Optometry

  • Optometrist
  • Carson, CA
  • NPI 1457938409
  NPD (past)
• Yuan Optometry, a Professional Corporation

  • Clinic/Center
  • Carson, CA
  • NPI 1770154049
  NPD (past)

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

{
    "created_epoch": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1427344522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17100 NORWALK BLVD STE 107",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032750",
            "telephone_number": "562-402-1525",
            "fax_number": "562-867-7046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 NORWALK BLVD STE 107",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032750",
            "telephone_number": "562-402-1525",
            "fax_number": "562-867-7046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONG",
        "first_name": "BRIAN",
        "middle_name": "MATTHEW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-27",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14146TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIAN",
            "last_name": "FONG",
            "middle_name": "MATTHEW",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Maricela Flores
• Minerva C Flores
• Sarah Kaitlyn Flores
• Taylor Flores
• Garrett Flowers
• Kelly Fong
• Jacqueline Claire Fontenot
• John Ford, M.D.
• Fountain of Youth Cosmetic Center
• Precious Fragozo

• Optometrist in Cerritos, CA
• Providers in Cerritos, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.