Individual provider Active NPI

Howard Fong, RPH, MBA

  • Pharmacist
  • San Gabriel, CA
National Provider Identifier
1558618124
Registry record updated Aug 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
29156 Issued in CA
Practice address
711 E Hermosa Dr
San Gabriel, CA 91775-2327
Phone
(626) 285-2658
NPI assigned
Aug 13, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 29156 CA Primary

Addresses

Primary practice location

711 E Hermosa Dr
San Gabriel, CA 91775-2327

Mailing address

711 E Hermosa Dr
San Gabriel, CA 91775-2327
Phone (626) 285-2658

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
Credentials
Master of Business Administration, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
29156CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344816000000",
    "number": "1558618124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 E HERMOSA DR",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917752327",
            "telephone_number": "626-285-2658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 E HERMOSA DR",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917752327",
            "telephone_number": "626-285-2658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONG",
        "first_name": "HOWARD",
        "name_prefix": "Mr.",
        "credential": "RPH, MBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-13",
        "last_updated": "2012-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "29156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Gabriel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2012; 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.