DR. ALLEN GARY FONG M.D. NPI 1477834463

NPI Information

NPI: 1477834463
Provider Name: DR. ALLEN GARY FONG, M.D.
Classification: Otolaryngology - 207YX0905X
Entity Type: Individual

Specialization: Otolaryngology/Facial Plastic Surgery

Address:
2039 FOREST AVE
STE # 201
SAN JOSE, CA
ZIP 95128
Phone: (408) 806-1565
Get Directions

DR. Allen Gary Fong, M.D. is an otolaryngology/facial plastic surgery otolaryngology in San Jose, CA. The provider is an otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. DR. Allen Gary Fong, M.D. NPI is 1477834463. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2039 FOREST AVE
STE # 201
SAN JOSE, CA
ZIP 95128
Phone: (408) 806-1565
Fax: (408) 741-1595

The enumeration date for this NPI number is 9/2/2011 and was last updated on 9/2/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207YX0905X	Otolaryngology	Otolaryngology/Facial Plastic Surgery	C36904	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	A36400	MEDICARE UPIN	CALIFORNIA
2	AF7272672	OTHER		BNDD
3	00C369040	MEDICARE PIN	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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