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NPI Code Detail

MEDICARE: HOWARD W FONG PHARMD

MEDICARE: HOWARD W 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
1183500000XPharmacistRPH47499CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RPH47499OTHERCACALIFORNIA STATE BOARD OF PHARMACY

General Provider Information

NPI Number : 1679989362
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOWARD W FONG PHARMD
Provider Business Mailing Address
First Line : 10861 LE CONTE AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90024
Country : US
Telephone Number : 310-824-5013
Fax Number :
Provider Business Practice Location Address
First Line : 10861 WEYBURN AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90024-2957
Country : US
Telephone Number : 310-824-5013
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2014
Last Update Date : 07/02/2014

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Directions to “ HOWARD W FONG PHARMD” Practice Location

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