Karen Ann Fong MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G70251 Issued in CA

Legal business name

KAREN ANN FONG MD

Doing business as

Asante Medical Group

Practice address

1551 Bishop St
Suite 310
San Luis Obispo, CA 93401-4635

Phone

(805) 242-4455

Fax

(805) 547-1395

NPI assigned

Oct 25, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Karen Ann Fong, MDNPI 1851396816

Title

Owner

Phone

(805) 242-4455

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Asante Medical Group Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Karen Ann Fong, MD

  • Internal Medicine Physician
  • San Luis Obispo, CA
  • NPI 1851396816
  Medicare reassignment NPD Authorized official
• Charlene A Sheridan, N.P.

  • Nurse Practitioner
  • San Luis Obispo, CA
  • NPI 1245214469
  NPD (past)

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362528000000",
    "number": "1629321849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1241 JOHNSON AVE",
            "address_2": "#322",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013306",
            "telephone_number": "805-242-4455",
            "fax_number": "805-547-1395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 BISHOP ST",
            "address_2": "SUITE 310",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014635",
            "telephone_number": "805-242-4455",
            "fax_number": "805-547-1395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAREN ANN FONG MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-25",
        "last_updated": "2013-03-06",
        "status": "A",
        "authorized_official_last_name": "FONG",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-242-4455",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G70251",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G70251",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA MD LICENSE",
            "identifier": "G70251",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Asante Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andrea Kamm, LMFT
• Adam Kandil
• Alexandra Kanemaru
• Abraham Kaplan
• Lucas Douglas Karaelias, M.D.
• Karen E. Goodrich, M.D. Inc.
• Karen M Scott M a
• Karen Schneller Licensed Marriage and Family Therapist Inc.
• Sandra Christa Karlic-Hiner, D.C.
• Elizabeth Andrea Karsh, MS

• Internal Medicine Physician in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.