Nicholas William Fong, PA-C is a medicare enrolled "Physician Assistant" in Moraga, California. He went to Rocky Vista University College Of Osteopathic Med and graduated in 2021 and has 3 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice La Clinica De La Raza Inc and his current practice location is
170 Sandringham Dr S, Moraga, California. You can reach out to his office (for appointments etc.) via phone at
(925) 350-9222.
Nicholas William Fong is licensed to practice in California (license number 60749) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1205587607.
Provider's Profile
| Full Name | Nicholas William Fong |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Experience | 3 Years |
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| Location | 170 Sandringham Dr S, Moraga, California |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Nicholas William Fong attended and graduated from Rocky Vista University College Of Osteopathic Med in 2021
NPI Data:
- NPI Number: 1205587607
- Provider Enumeration Date: 01/17/2022
- Last Update Date: 04/14/2022
Medicare PECOS Information:
- PECOS PAC ID: 6305233222
- Enrollment ID: I20220425000393
Medical Identifiers
Medical identifiers for Nicholas William Fong such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1205587607 | NPI | - | NPPES |
| 1192651 | Other | | NCCPA |
| 60749 | Other | CA | CALIFORNIA PHYSICIAN ASSISTANT BOARD |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363A00000X | Physician Assistant | 60749 (California) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| La Clinica De La Raza Inc | 1557258282 | 107 |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nicholas William Fong is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Nicholas William Fong, PA-C
170 Sandringham Dr S,
Moraga, CA 94556-1931
Ph: (925) 350-9222 | Nicholas William Fong, PA-C
170 Sandringham Dr S,
Moraga, CA 94556-1931
Ph: (925) 350-9222 |
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