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NPI Code Detail

MEDICARE: DR. MILLIE FONG PHARMD

MEDICARE: DR. MILLIE FONG PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist72427CA

General Provider Information

NPI Number : 1508253154
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MILLIE FONG PHARMD
Provider Business Mailing Address
First Line : 9180 FRANKLIN BLVD
Second Line :
City : ELK GROVE
State : CA
Zip : 95758-9501
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9180 FRANKLIN BLVD
Second Line :
City : ELK GROVE
State : CA
Zip : 95758-9501
Country : US
Telephone Number : 916-427-3739
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2015
Last Update Date : 04/22/2015

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Directions to “ DR. MILLIE FONG PHARMD” Practice Location

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