Individual provider Active NPI

Benjamin Zee Fong, MD

  • Family Medicine Physician
  • San Francisco, CA
National Provider Identifier
1467464867
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G49382 Issued in CA
Practice address
1 Shrader St
#500
San Francisco, CA 94117-1016
Phone
(415) 831-6441
Fax
(415) 831-6443
NPI assigned
Aug 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G49382 CA Primary

Addresses

Primary practice location

1 Shrader St
#500
San Francisco, CA 94117-1016

Mailing address

1 Shrader St
#500
San Francisco, CA 94117-1016
Phone (415) 831-6441

Other identifiers 1

IdentifierTypeStateIssuer
00G493820MedicaidCA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G49382CAMDFamily Medicine Physician
49382CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467464867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SHRADER ST",
            "address_2": "#500",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941171016",
            "telephone_number": "415-831-6441",
            "fax_number": "415-831-6443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SHRADER ST",
            "address_2": "#500",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941171016",
            "telephone_number": "415-831-6441",
            "fax_number": "415-831-6443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONG",
        "first_name": "BENJAMIN",
        "middle_name": "ZEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G49382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G493820",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.