Active NPI
Steve Fong
- Student in an Organized Health Care Education/Training Program
- Garden Grove, CA
National Provider Identifier
1639452279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 00000000
- Practice address
- 12900 Garden Grove Blvd
Suite 214a
Garden Grove, CA 92843-2006 - Phone
- (714) 636-6286
- NPI assigned
- Sep 20, 2011
- Last updated
- Sep 20, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 00000000 | CA | Primary |
Addresses
Primary practice location
12900 Garden Grove Blvd
Suite 214a
Garden Grove, CA 92843-2006
Mailing address
4771 E Pacific Coast Hwy
B
Long Beach, CA 90804-3242
Phone (415) 490-8361
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00000000 | CA | MD | Foot & Ankle Surgery Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316476800000",
"number": "1639452279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4771 E PACIFIC COAST HWY",
"address_2": "B",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908043242",
"telephone_number": "415-490-8361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12900 GARDEN GROVE BLVD",
"address_2": "SUITE 214A",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928432006",
"telephone_number": "714-636-6286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONG",
"first_name": "STEVE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-09-20",
"last_updated": "2011-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": "00000000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.