| Dennis Y. Fong, M.d., Professional Corporation | |
|
108 La Casa Via Suite 104 Walnut Creek CA 94598 | |
| (925) 934-2333 | |
| (925) 934-2688 |
| Full Name | Dennis Y. Fong, M.d., Professional Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 108 La Casa Via, Walnut Creek, California |
| Authorized Official Name and Position | Dennis Yunming Fong (PROVIDER) |
| Authorized Official Contact | 9259342333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dennis Y. Fong, M.d., Professional Corporation 108 La Casa Via Suite 104 Walnut Creek CA 94598 Ph: (925) 934-2333 | Dennis Y. Fong, M.d., Professional Corporation 108 La Casa Via Suite 104 Walnut Creek CA 94598 Ph: (925) 934-2333 |
| NPI Number | 1245336809 |
|---|---|
| Provider Enumeration Date | 09/14/2006 |
| Last Update Date | 11/20/2020 |
| Medicare PECOS PAC ID | 0345277448 |
|---|---|
| Medicare Enrollment ID | O20050720000654 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245336809 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G83720 (California) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Dennis Yunming Fong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356364871 PECOS PAC ID: 5890793715 Enrollment ID: I20061130000529 |
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