Fong, Theodore T.

Fong, Theodore T. is an individual health care provider with primary practice located at 7373 West Ln , Stockton CA 95210-3377. He recently has only one registered license in Allopathic & Osteopathic Physicians / Critical Care Medicine, which is considered as his primary health care specialty. Fong, Theodore T. can be contacted via phone (209) 476-2000.

Contact Information

Primary practice address
7373 West Ln Stockton CA 95210-3377
Phone: (209) 476-2000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X G77016 California

Profile Details

NPI number 1316025208
LBN Legal business name Fong, Theodore T.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Dec 2nd, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316025208 NPPES
California MEDICAID 00G770160

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