Active NPI
Nora Lillian Fong, M.D.
- General Practice Physician
- Manhattan Beach, CA
National Provider Identifier
1609248053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- G65297
- Practice address
- 425 15TH St.
Manhattan Beach, CA 90266 - Phone
- (310) 802-8760
- NPI assigned
- Oct 26, 2015
- 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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | G65297 | CA | Primary |
Addresses
Primary practice location
425 15TH St.
Manhattan Beach, CA 90266
Mailing address
PO Box 3266
Manhattan Beach, CA 90266
Phone (310) 546-7686
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G65297 | CA | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445817600000",
"number": "1609248053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3266",
"city": "MANHATTAN BEACH",
"state": "CA",
"postal_code": "90266",
"telephone_number": "310-546-7686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 15TH ST.",
"city": "MANHATTAN BEACH",
"state": "CA",
"postal_code": "90266",
"telephone_number": "310-802-8760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONG",
"first_name": "NORA",
"middle_name": "LILLIAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-26",
"last_updated": "2015-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "CA",
"license": "G65297",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manhattan Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.